First, understand that this is a business decision for your insurance company.  They are using their contracts to determine whether to pay for the coverage, and they seem to have found another way to deny based on how your situation lines up with your contract.

Your job is to:

(1) Get all objections from them in writing so you can address them all at once.  Reply to the most recent letter in writing asking for all of the reasons why the surgery is being denied and what would need to be done to satisfy those requirements

(2) Thoroughly respond in writing to every issue that they provide.

(3) Include the financial benefit TO THEM for approving your surgery in your response.  While this isn't absolutely necessary to obtain approval, they will be much more likely to approve a "borderline" patient (from a contractual standpoint) if they think it will be more profitable over the long-term.  Fortunately, weight loss surgery is an extremely profitable investment for the insurance company over the long-term.

This page walks through the instructions and has a sample health insurance appeal letter.

You should also seek the assistance of the HR department from your husband's company.  They (along with their employee benefits broker or consultant) can work with the insurance company on your behalf to speed up the process.

Good luck!

Jeff

Please let me know how this works out for her. I have United Health Care as well and am beginning the process of the insurance stuff. I have UHC on my own (so no employer) hope it works out for her!

I have a question if anyone can help. My company also requires a 6 month medically supervised diet but I am considered a revision having my band removed 3-21. Do you think they are going to make me do this diet thing? It is listed as a requirment for surgery but not under the revision part. I am so stressed over this...

I had No Insurance, My surgeon referred me to them. I called filled out the paper work. I did before hand go get copy's of medical records that showed any co morbidities, degenative joint disease. If you have high blood presser or diabetes any thing that looks bad in your medical will help.  I had a job so it might be easier for you being on disability. My doctor felt the surgery would help all my  other medical problems.  It have greatly improved my life. I still have a long way to go but so thankful for what was given to me! Feel free to contact me if I can help. I had never heard of voc rheb before my Dr. told me about them, They paid for the surgery the Meds, and my appts. for one year with the wl surgen.   Heidi 

Thank You!!!