Denied... UHC

[hersheymalone 0]

I just found out that I was denied lap band surgery. I am borderline... 38 BMI. Any suggestions? I am heart broken and don't know what to do.....

[PATCHELTON 0]

I have a different insurance (Blue Choice) but my BMI was 37-38. With that under my plan you had to have 2 or more co-morbidities (diabetes, sleep apnea, high blood pressure, high cholesterol, reflux, joint arthritis--basically any ailment affected by excess weight). I had all of the above except diabetes. Check with your insurance again. I would definitely appeal the denial.

My insurance paid for the surgery, a night in the hospital, but they don't pay for fills. Go figure. . .

[missinme 0]

Don't give up just yet....if you have an associated co-mobility such as diabetes, high blood pressure or high cholesterol then you have an argument with your provider. Also pick up the book "Weight Loss Surgery for Dummies" there is a section on what to do when the insurance company doesn't agree with your physican decision.

My BMI was less than your and I was just banded with insurance approval this Monday. I am sore as all get out, but do NOT regret my decision.

Good luck.

[hersheymalone 0]

I am just sick about this... I never use my insurance and then when I decide I want to, they deny me. Crazy.... I just wonder how the appeal works... Argggg......

[newimage 2]

Check you insurance policy before you appeal. There maybe an exclusion.

[hersheymalone 0]

only is exclusion is that you can't of had a weight loss surgery during your life time.

[Jodi_620 37]

You don't have any weight related health conditions? I have UHC and like most insurances they will not make any exceptions to the guidelines. You have to be 35-40 with co-morbities or 40+.

[hersheymalone 0]

I have hypertension, but do not take medicine. I have pitting endema. Pain in my back and knees, but still denied.... I don't know what to do??

[Chris61 0]

I was on the border in regards to BMI. I can forward you a copy of a letter that we used. I was wondering if the doctor just said pain in the knees or other issues or did he use technical names? I would talk witht he doctor and see how he did the letter.

Chris

[KingsFan 0]

I just found out that UHC denied me because my BMI is too low (35). I already had my doctor write a letter and I will send off an urgent appeal tomorrow. My surgery is scheduled for September 12 and UHC said they might treat the appeal as urgent and decide within 72 hours. Good luck to all of us who are at the mercy of insurance companies!