5 year weight proof history
on 6/7/21 8:41 pm
Hello. I am getting ready to schedule my first appointment for wls. I watched a seminar and am nervous but looking forward to the next step.
I started looking into my insurance (UHC) and saw some people mention the 5 year weight history although this may vary by plan I believe. I tried to call and speak with a UHC worker and was basically told I had to have the appointment and see if I qualified and they were not able to tell me via phone.
I have not seen doctors super regularly over the last 5 years. I've also been pregnant three times (one loss) Gaining 65+ lbs losing 85 only to gain 85+ back. I went to my doctor several times about weight loss and tried various diets, so my weight during those has fluctuated, but again, never consistent doctor visits and no consistent 5 year history to go off of.
Now I'm feeling bummed that I may be denied despite meeting the other criteria.
Any insight on what happens in these sort of cases-- pregnancy/inconsistent visits/ weight changes?
Every plan is different so really your first step is to understand what your coverage is and what those requirements are. Your insurance company should be able to tell you what their requirements are before you meet with a surgeon. For example, they may require a center of excellence be used, you should know that before you start or you could end up going through one process and then having to switch. I would call your insurance back and stay on the line until someone can walk you through what the plan requirements are -- also see if you have a nurse advocate with your plan or a benefits admin with your company that can help get you talking to the right person.
on 6/10/21 7:40 pm
I doubt many people have 5 years of valid history documented. Nevertheless the best route forward is to find a great doctor and let his staff work it out with insurance bureaucrats. They have the experience and know which buttons to push.