ABOUT TO SCREAM!

Sorry guys, just needed to get this out.

Ok, so I'm in the beginning phase of gastric bypass and my insurance tells me that I have no requirements other than a BMI over 40 (which I do) however my surgeons office is telling me I need a 5 year history plus a six month weight loss trial (don't mind the six months). But there is NO way I can get together five consecutive years of having a 40+ BMI.

UHC Choice Plus is my ins company and they personally called and spoke to the surgeons office coordinator. They want this in writing. So UHC calls me back and suggest I get in touch with Human Resources, which I did. And she is telling me it's all online. I have been a member of myuhc.com for two years and I have NEVER seen anything about the requirements, let alone anything that even shows that they cover RNY.

I know every plan is different, it's all down to the plan that your employer buys. So it's very specific to the Estée Lauder company whom I work for.

What else can I do at this point???

Have you been to the doctor at least annually in the last 5 years?  All they need is a note with the weight listed on them. 

I have a few years records, however in 2011 I lost a lot of weight from an unhealthy crash diet, so that's the weight I have on record for that year which dropped my BMI way down so I know I would be denied because my weight dropped so low that year.

Call HR back and tell them you cannot find the information online.  Ask them to give you the exact URL where you can find it.

I did, hopefully she will call me back. She sounded like she couldn't be bothered and that there was nothing on her end she could do about it. It's just super frustrating.

I got my weight history from my gynecologist because I went there regularly every year. Could you try that!

Unfortunately, I didn't go to the dr as often I should have. For most of those years I didn't have insurance, and for one of the years my weight dropped pretty drastically from an unhealthy diet. So for 2011 it's way to low to be approved. And I cannot find any appointments I and at all in 2009...

My surgeon's office told me the same thing. I called my insurance myself, and got them to email me the 36 page policy on bariatric surgery.  No where did it say that. It is standard, but not always.

 

I would call UHC and tell them you want them to email you a copy. I can never find stuff online.

 

 

I'll try UHC again. The reps say that UHC themselves dont have access to that info either :/ I'm beginning to think that no one knows what is required haha it's so confusing and frustrating.

My insurance company also required the 5 year report.  They just wanted it to see my weight history for the last 5 years.  I only had to do a 3 month weight loss with my physician.  They wanted a 5% weight loss before I would be considered for the weight loss; which I did but then I had to lose another 15 lbs per my Bariatric Center 5 weeks before surgery on the Opti-Fast Shakes.  Don't give up, they just want all their i's dotted and their t's crossed!