Undocumented Weight Loss Attempts

[elp322 0]

Hi everyone,

My name is Erika and this is my first post here. All of my life I have been overweight and after failed attempts, one right after the other, I am seriously considering getting the lapband.

I have made arrangements to go to a lapband seminar with a doctor I am considering getting the procedure through. The problem that I think I may have is that I haven't had medical insurance for years so I do not have any medical documentation that shows I am apparently unable to lose weight. All I have is medical records from when I was younger and went to the doctor all the time. Those files will show that I have always been overweight.

My question is do you think that my insurance (Aetna) will attempt to deny me based on not having medical documented proof in the last few years? I have receipts from where I've purchased Weight Watchers books, exercise equipment, etc.

Any advice you can give me is greatly appreciated!

[laurenlee 1]

from what i understand, they need to see documented weight loss within the last 2 years. double check with Aetna that you have bariatric benefits. if not, you don't need to do the 6 month documentation. if you do, join WW for 6 months - start now - and that counts. good luck

[baps813 0]

Hi everyone,

My name is Erika and this is my first post here. All of my life I have been overweight and after failed attempts, one right after the other, I am seriously considering getting the lapband.

I have made arrangements to go to a lapband seminar with a doctor I am considering getting the procedure through. The problem that I think I may have is that I haven't had medical insurance for years so I do not have any medical documentation that shows I am apparently unable to lose weight. All I have is medical records from when I was younger and went to the doctor all the time. Those files will show that I have always been overweight.

My question is do you think that my insurance (Aetna) will attempt to deny me based on not having medical documented proof in the last few years? I have receipts from where I've purchased Weight Watchers books, exercise equipment, etc.

Any advice you can give me is greatly appreciated!

Not to discourage you, but I have Aetna and had all the documentation and they still tried to deny me, but, if this is something you want, stay on them! I called them daily to approve me. Make them talk to you in plain English so you know what they require. GOOD LUCK!

[Chris61 0]

I would go to your regular doctor with all your past medical records and with all the items that you have from weight loss programs and have him/her put that in your medical file and then when he does his letter to the labband doctor he can add those in. I can forward you a copy of a letter that I used that showed the weights etc. Do keep in mind like everyone says each insurance is differant on how they do things along with your doctor. You might also have to a 6month deal as welll. Also another thing would be any doctor you went to even when you did not have insurance Ie: OBGYN,ER etc.. I had that problem with a couple of years but was able to use some past information. I hope that this helps you out. If you have any questions just ask.

Chris

[paisleypea 1]

Chris - can I get a copy of that letter too?

I am struggling with the "at least a five-year history of morbid obesity supported by medical record documentation". i got some of my old medical records of recent years and sure enough, not big enough on the records ---- cuz you think I want to go when I am my biggest? uh, no! plus I always "dieted" before the annual visit to the OB/GYN! ugh!

I threw out all my WW materials, my time with a trainer, etc. etc.

I did have a weight high enough from 2001 and my family doc wrote in the record, "history dating back to 2001 of BMI greater than or equal to 35" ---- any idea if that works for insurance? The other dr. records are slow to come in as they are "in storage" and must be dug out I guess. They have 30 days, but that seems like an eternity to me now.

I am so mad that I am "obese" but not "obese enough". I've struggled with my weight my whole adult life. I've tried and tried and tried and lost and gained and lost and gained and you all know the drill. Seems so frustrating to get this approved!

[janicexp 0]

Chris,

I am having the same problem and was wondering if I could too have a copy of that letter. I did not know that we had to have documented weight loss attempts. I've tried everything from diet teas, nutrisystem, weight loss pills, to the gym. Had I known that we needed documention I would have kept them all! If you could send a copy, it would be greatly appreciated.

-- Janice. :]