UHC, ~57 BMI, lack of weight loss history?

ByeByeBonBon · 07-22-2008, 08:07 PM

A few days ago I called and found out that yes, the Band is covered by my insurer (Lucent, UHC Choice Plus), and the only requirements, I was told, were a BMI > 40 and/or co-morbidities and a five year history of weight loss. Currently I'm 5'8 and about 370lbs, with a BMI just under 57. Also, next week my blood work results come in, but at the moment I'm only aware of the beginnings of hypertension.

My question is, what exactly have your insurers required as far as the five year history goes? Physicians records, just a personal list from yourself? Would having such a high BMI make approval more likely? I've lived in three states in the past five years and haven't been up to date with doctor visits. While I do generally remember my weight patterns, I'm not sure if I'll be able to present physical copies.

Has anyone been in the same situation, or have any suggestions?

glorybee123 · 07-22-2008, 08:33 PM

I think they want documents or copies of your medical records that show your weight from the doctor's office. I know someone who was missing a year and they accepted a dated photo instead.(the date was from the camera itself). She also submitted a birthday photo showing her cake with her age on it. Good luck!

AliNSanDiego · 07-22-2008, 09:19 PM

I have uhc choice plus. I feel very lucky to have been approved in less then 1 week.

I started the process at the end of may and got everything done and had my band put in July 9th.

For weight documentation I filled out my paperwork at my Surgeons office stating which programs I tried. I also went to my PCP and requested my entire medical file (provided it to my surgeon) which showed 3 years of me being overweight (I had only been seeing that doc for 3 years, been overweight almost all my life). That was enough for me to be approved.

Good luck!!!

UHC was very easy to deal with.

lafrogura · 07-22-2008, 09:21 PM

I actually had my doctor write a letter stating that for x number of years that my weight had been an average of x # of lbs at each visit. I even did not have a family physician during those years. I had my gynecologist write the letter.I could not even be weighed in her office due to her scale only went up to 350lbs and i weighed more than that. That was enough for my insurance.

Grievous Angel · 07-22-2008, 09:30 PM

I also have UHC and they took the 5 years of information from my Cardiologist and PCP notes; fortunately I was able to produce the last four years from my Cardiologist and five years ago from my PCP. I know the Administrator at my LAP-BAND^® Center didn’t actually have to supply copies to UNH because she took the info from me verbally but said I would need copies if challenged. Can you call doctors from the other states because they should still have your records? I was told that my doctor’s scribbled notes would be good enough if I ever had to produce them. It all hinges on whether they ask for proof so I suggest getting what you can and submit your information. Good luck!

southerngirl24 · 07-22-2008, 11:58 PM

I have UHC Choice and I was approved in about two weeks. I used records from my PCP and also my OB GYN. I had two years with no history except my OB GYN so I also wrote a letter to detail what plans I attempted. They also used the information from my intake forms and history.

skep · 07-24-2008, 04:44 PM

I have the same issue. I have a 5 year history but only three of those was my BMI over 35. The reason was that I was in a weight loss study on weight meds with monthly meetings with a dietitian. The study lasted for 56 weeks. When I finished the study I started on Nutrisystem. My surgeon's office is saying that I won't qualify since I had only 3 of the last 5 years being over 35. At no time though was I less than 30 BMI. I'm very frustrated thinking that because I put forth a tremendous effort which did not work over the long run, I am being punished. So do I wait for 2 more years without dieting or do I challenge the insurance company?