Question:
United Health-5 year weight history

I am writing for a friend. She has not been over 40 BMI for 5 years only about 3 years over 40 BMI's. She does not have currently any illnesses other then her knees hurting because of her weight and does not see a doctor regularly. She has about 4 year 8 months of weight history ranging from 35-44 BMI. BP and Diabetes runs in her family and she so desperately wants to get gastric. Any suggestions to help her get approved.    — tayee24 (posted on September 25, 2008)

September 25, 2008
I had to deal with this as well! All they need is one weigh-in from any point in the year. So if you have one on Dec 18th 2008 and then another on Jan 2nd 2009 that is two years worth. They also do not need to be five years in a row! I gave a weights from when I was ages16, 19, 27, 28, and 29 and it was approved. I will put the extra statement that my BMI was much higher and I had a few co-morbidities though.
   — stutzman

September 25, 2008
If her health insurance covers the surgery then she shouldn't have any problem getting approved. However, the insurer might want her to join a 6 month weight management class before she will be approved. She can go to her doctor for a workup and see what happens. She should qualify if her BMI is over 40 for at least 2 years. I don't think she has to have any medical conditions, as long as she is overweight, that should do it.
   — LA2194

September 25, 2008
I know with me all I had to do was show 6 months of diets I tried & I didn't have alot of problems either. She shouldn't have a problem because of diabetes & joint pain. Tammie
   — tammie71

September 25, 2008
Tell her to talk to her doctor. When I was referred I had a BMI of 42 and back pain. But after the doctor began looking through my medical history, he was able to find other co-morbidities that would qualify me such as stress induced incontinence, stage 2 kidney disease (didn't even know I had that), borderline high blood pressure, high cholesterol, things of that nature.The insurance companies want us to be healthy and this procedure has proven to "cure" many of the ailment I listed above. Lots of Luck to her!
   — Mrsdoubleu

September 25, 2008
I have UHC insurance and I just found out today that I am approved. The first time they denied me because my pcp only submitted 3 years of weight documentation. I had to go back to them and have them forward the additional info. I also had my gyn submit the documentation just to be on the safe side. It took a week for them to review it again. I also called them everyday otherwise it could have taken 30-45 days. I am scheduled for surgery on Oct 13 so I didn't have that time to waste. Good luck to your friend.
   — MastaP

September 26, 2008
UH is the best insurance for this surgery. I actually switch from BCBS of IL to UH and was approved fast. I didnt have any illnesses. I was healthy except for my weight. I switch in Jan. 2008 and was approved March 2008. But,as mentioned, your friend will only need 1 documented weigh-in and Blood pressure reading for 5 years. So that's five recordings. So, I'm sure she will be fine and good luck!
   — lakia1908

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