DENIED x1

[dasundlvr 0]

HELLO EVERYONE!! I WAS WONDERING HAS ANYONE BEEN THROUGH WHAT I AM GOING THROUGH? I SUBMITTED TO MY INSURANCE COMPANY (UNITED HEALTH CARE) AND WAS DENIED DUE TO NO CO-MORBIDITIES. MY BMI WAS 36 AND I HAD JUST LOST LIKE 25 POUNDS THAT BROUGHT MY BMI DOWN AT THAT TIME. MY DOCTOR WROTE ME A LETTER TO APPEAL IT AND SHE HAD ME TO WRITE A LETTER ALSO WITH ME EXPAINING MY FAMILY HISTORY TO THEM. MY DAD IS A THIRD GENERATION DIABETIC AND ALSO HAS HIGH BLOOD PRESSURE. MY MOM HAS BLOOD PRESSURE. MY GRANDMOTHER AND GREAT-GRANDMOTHER DIED FROM DIABETIES. THAT IS WHAT I EXPAINED TO THEM ALONG WITH MY PAST ATTEMPTS AT LOSING WEIGHT AND RE-GAINING IT BACK (AND THEN SOME!) I ALSO EXPLAINED TO THEM THAT SINCE MY DOCTOR'S LETTER WAS WRITTEN THAT I HAD GAINED MORE WEIGHT, NOW MY BMI IS AT 39.3. I AM STILL UNDER THEIR 40 MARK BUT WITH MY FAMILY HISTORY IS IT POSSIBLE THAT I CAN STILL BE APPROVED?? THIS SITTING AND WAITING THING IS TERRIBLE!!! I JUST WANT SOME ENCOURAGEMENT, IF ANYONE HAS BEEN THROUGH WHAT I HAVE BEEN THROUGH. MY PAPERWORK ALSO SAID THAT I CAN GO AS HIGH AS CONGRESS, SO DON'T THINK THAT I HAVE NOT ALREADY TALKED TO A REAPRESENTATIVE THAT SAID SHE WOULD BE "GLAD TO GO TO BAT FOR ME!!":smile: JUST WONDERING IF MAYBE I COULD GET SOME FEEDBACK FROM SOME OTHERS THAT MAY HAVE BEEN DOWN THIS ROAD THAT I AM GOING DOWN??

[JamieNP 20]

I have Tricare and was denied, appealed and was approved. It wouldn't take but a few pounds for you to be at the 40 mark if that is what it takes to get approved. Then have your surgeon's office resubmit your new weight. I know that your insurance company is a bugger to get them to do ANYTHING. But sounds like if you are at the 40 mark and they still deny, you have a case for obesity law.