She did have a 4 year history of BMI over 40.  Our insurnace requirements were to have a BMI of >40 with no co-morbidities or >35 with at least 2 co-morbidities.  She was denied due to lack of 2 year history of obesity as defined above.  the reason being, originally 4 year history of proof of obesity was submitted, but within those 4 years, she had an office visit where her bmi dropped below 40 during one of the years.  But she also had a recorded weight of a bmi of over 40 in that same year.  So when filing the appeal, we did not include that one office visit because she did have other office visits in the same year where she was clearly way above 40.

Have you been denied?  Or are you still in the approval process?  Who do you have insurance with?

Yes, actually that was the reason my daughter was denied at first, but we appealed and won the appeal.  Normally, if your BMI drops below the 'required' BMI during that 5 year history, you will get denied.  In our case, we only needed a 2 year history, not 5.  We have Aetna insurnace.

Nan

Anyone have issues with 5 year weight history for insurance purposes and some years that your BMI didn't quiet meet the obesity level

Congratulations!!!  That is wonderful that your surgeon fought for you!  Good luck with your surgery!

Nan

 

Hi all,  I saw my surgeon today and we discussed him doing a peer to peer with the medical director at CIGNA.  He didn't think that it would make a difference but promised he would fight for me.  Guess what!  Success!!!  I'm still in shock!  Guess he had to go through every visit with him since band was placed in 2007 and stress the reasons over and over again as to why I'm having intolerance issues with the band.  Got my approval!!  Scheduled for sleeve surgery on December 8th.  i love Dr. Srikanth!!!