Denied again

[seanmama 0]

Hi all,

After being very patient I just found out that United Healthcare denied me again. I had filed a comprehensive appeal, but they still are not wanting to preapprove.

I am curious to see what the letter is going to say. I am going to file a second appeal and request a specialist review- the surgeon suggested this.

I am confused as I know that many bandsters have had success with appeals, and I thought I would too.

This is most upsetting.

Seanmama

[bethaniestarr 0]

I'm so sorry to hear that.I'm selfpay so thankfully i didnt have to go thru this with insurance.Hope it works this second time.Good Luck

[marsha 0]

Seanmama,

Why did they deny coverage? What was their explanation? I'm curious because I also have United Healthcare and will be submitting for approval soon (I just have to get results of one of my tests before submitting).

I wish you a lot of luck! Don't give up..keep fighting!

Marsha

[seanmama 0]

Thanks for the kind words. As soon as I get the letter in the mail I will let you know their reason. Maybe someone will have advice or opinion.

Marsha, my initial request was denied because I am not within the defintion of morbidly obese and my comorbidities apparently do not qualify me.( BMI 38- arthritis, GERD, brderline high blood pressure, high triglicerides)

Whatever. I am very despondent.

Seanmama.

[Mahoney 1]

Seanmamma,

Sorry to hear about the denial. It is a shame that the insurance game revolves around that magic 40 BMI number. The difference between 38 and 40 is only a 32 oz soda and a hunch. Good luck with the appeal - I hope everything works out!!!

Bob

[marsha 0]

Seanmama,

I'm in the same boat as you. My BMI is 36 I have arthritis, gerd, and insulin resistance. I've heard about a few obesity lawyers that are on the web somewhere that can help get insurance approval. I'm not sure what the cost is or how many people they actually get approval for but it might be worth looking into.

I wish you a lot of luck and I'm thinking of you!

Marsha