I'm Fighting a Battle that May Never Happen

I find myself worrying about insurance before I've even started. United Healthcare Choice Plus does pay for bariactric surgery, with the usual stipulations. There is one that is driving me nuts. Previous non-surgerical attempts to lose weight. Been there done that 100 times over, but I don't have any documentation. The past 4 years have been really hard for me. I had a total knee that ended up with a staph infection, I was given two choices, amputation or fusion. I had 9 surgeries and was very sick for a long time. The doctors were concerned that I wasn't eating. It didn't matter that my apetite was gone and I hardly ate, I was still in the wheelchair 100% of the time, and unable to do any type of exercise, but as always I continued to gain weight, only a few pounds, but it sucks. Am I worrying for nothing? I have sat down and documented the various diets over the years, but I really don't have "documentation." Can I stop worrying?

Dear Trudy, It really sounds to me like with all the other health problems you have had, and are having now-that it SHOULDNT be an issue, but you never know with the insurance companies....I will pray for you that they find your co-mobities and the evaluation you filled out on your own to be enough to approve you without the delays. I know its so hard at this stage right now, but please keep the faith..with all the problems with your knee and the wheelchair and still gaining weight, I think it would be pointless for them to make you go through that for 6 more months, you know? I will be thinking of you, praying for the best and please post and keep us updated. Have you already seen the bariatric surgeon for your consult and if so-what did they say and if not, have you chosen who you are going to yet? Good luck, Trudy....Love, Janet

United Health Care is one of the easiest companies to get approval from as long as your plan doesn't have the exclusion. I had my approval without any hassles. I went for my consult the day before Thanksgiving and the office girl said it would be the following week before they sent it in for approval due to the holiday.She said dont expect an answer until after the first of the year because they usually want to hold off approving stuff when it gets close to the end of year. Sure enough I got my call Jan.2 that I had been approved and had my surgery 2/14/07. Good luck. Dannielle

I always think that going at them with both barrels loaded can not hurt so maybe you can just give a detailed account of every diet from your past....Include pre-diet wieght, dates you began and ended, ending weight, how much you gained back etc.....I did that and had a typed full page of all diets over abotu 18 years. With that, my insuarance waved my 6mo dr supervised diet and I was approved. Make sure they send in a detailed outline of your complete medical history and problems that support a need for weightloss. Good luck to you!!!!!!! Tami

Hey Trudy, STOP WORRYING and start doing. It will be up to you to make this happen. United will except your own documentation. I did not have any real "diets" or programs that I had been associated with but like you, plenty of diets and trys and attempts. So just start with a pad and paper and remember all the times you tried, what you did and when. Of course the dates dont have to be exact but if you think back you can usually remember pretty close. Then also list the things that make you eligible other wise. Your knee problem, and anyother issues. High BP or diabetes, heart issues, even down to bladder issues. If your BMI is over a certain # too! DON'T GIVE UP!!!!!!!!!! It took me 6 months to really get the ball rolling and then another 6 months of jumping thru hoops to get here, but Wed. 7th I will have my surgery! Keep the faith! I will pray for things to go easy and straight forward for you! Sugar Sims

Thank you all so very much! I feel much better about everything now. I'm working on my list of diets and I was shocked that I remembered so many of them. This will happen, I was wanting it now. I realize that it takes time and I want to do this right. Thanks for being here. I'm much more confident now. Trudy

Trudy welcome to the missouri Board first of all and please keep on trying and writing and make sure that all the (i's) are dotted and all the (t's) are crossed. As some have said that United is easy to get approval from but doesnt hurt to get it all right the first time. It will happened and if you do get turned down the first time dont give up you can appeal your case and there are people on here that can help you do that. My sister, Sugar, is having surgery tomorrow morning and she had to go thru a lot to get to this point but she is here now. So glad to meet you and please come back often. Jan