Paul - or any other insurance expert

I got my denial letter from UHC.  Our policy states that  I am to have had a diagnosis of morbid obesity for at least five years (in other words, BMI > 40).    I have not.  I have had a BMI > 35 for five years, with high blood pressure.  I also have a lot of family history of high blood pressure, heart attacks, obesity, and diabetes. Is there any need to appeal my denial?  Is the five year BMI > 40 absolute?

I know the surgeon didn't send in my weight history.  I had told them about my high blood pressure and the medication I take for that, but I don't know for sure if they included that information.  How do I go about sending in the information they are needing?  Do I call that an appeal, or how do I submit that to them?  Should I submit it myself, or should the surgeon's office?

My UHC is a policy administered for my employer, who is self-insured.

 

What State do you live in?  Is it a self funded plan or private plan?  If private you may be able to appeal to the state for an external review.  Check out the links on the left side and go to appeal rights by state. And....it wouldn't hurt for you to send in a nice letter, you can do it yourself, and appeal.  Stranger things have happened.