Obese v. Morbidly Obese and Insurance

Thin4Anisha · March 4, 2008

UHC, my insurance, only requires someone to be at least 21 yrs old (I am), have a BMI over 40 (I am at 44.4) and have a history for 5 years of being morbidly obese. What if you have been in varying levels of obesity (well documented), have documented weight loss attempts in those 5 years (was on Fastin for 2 years, lost 65 and have regained 130 as of now) for the last five years but have only hit the morbid category for the last year?

Anyone have experiences like this and got approved?

shortgal · March 4, 2008

I would say submit what you have. Do you have annual weigh ins from a Dr or Gyn that you can include? I would include the office notes showing a weigh in from any dr. you might have seen over the last five years.

I was missing doumented weigh ins from my physician and was denied for lack of documentation. Doesn't mean I wasn't obese all that time, I just couldn't prove it to the ins co. and was denied.

I self paid.

Thin4Anisha · March 5, 2008

Yes, I have a pretty consistent history with weight records. Five years ago I went in (in the obese category) and started Fastin (other half of phen phen) and had to go in to see my doctor every 3 months to check in. I lost weight but put it back on, which is also documented. So I can prove the obesity and the gradual gain that put me into morbidly obese (what a term!)

xgrl · February 9, 2009

My Insruance BCBS requires me to be morbidly obese for 3 years....I'm recently become morbidly obese (last year) and they tell me that the fact that I was obese for more than 3 years is not enough I have to be deathly obese for 3 years before they will consider covering the surgery....

Have to love insurances they want your health to get worse before they will pay for it to get better..jackasses

avanderhoof · February 9, 2009

I have UHC as well, but I have a HUGE group plan. I work for JP Morgan Chase. Our policy is amazing and they don't require the 5 year documents. With that said, I did submit weight history just in case. I had very sparatic history since I don't vist the Dr. regularly and it was still approved. I think that it varies per group plan what exactly is required, and also what board reviews your paperwork. It seems crappy, but it seems as there aren't a black and white set of rules to get approval.