Question:
Ins Surgery Guidlines changed for 2006

I have UHC Select EPO. For 2005 the guidelines were BMI of 40 OR greater than 35 with 2 co-morbidities but for 2006 the plan language changed and BMI has to be at least 40. Here I am at 39.6. Everything has been flowing along well until now. Any advise?? Do you think I have a chance of UHC still approving me?    — kc1978 (posted on January 16, 2006)

January 16, 2006
they cannot change the rules post enrollment period, that is fraudulent, prudential did that and it was reversed when they introduced a drug formulary post enrollment period, they are out of business.
   — walter A.

January 16, 2006
I would think that b/c you were already inrolled w/ the insurance the new quidelines would not apply to you. I would call the insurance company and ask them. If they say that the new guidelines apply to you, I would challenge them.
   — kizie23

January 16, 2006
I had UHC and I also had a BMI of 39.something and I was approved no problem.
   — smparker2

January 16, 2006
Not that this is probably a great idea or anything, but when my sister went for approval she was under the required wait. She decided to stop working out and start eating more unhealthy until she reached the required BMI...it's not the best way, but she did it, and says it was worth it. Good luck...
   — bubba45

January 17, 2006
If you are already in progress, that should still hold. Also, 39.9 rounds up to forty!
   — Novashannon

January 17, 2006
Who is going to measure your height? No one did with me...I told them the info---I am almost 5'6"--not quite- so I rounded my height DOWN for the BMI equasion to 5'5" thus I then became 40 BMI. Here I am-13 months later, I am now 28 BMI---Hurray!!!!!!!!! It is worth all the struggle you are going thru. Don't give up. It will happen.
   — Dec16-04

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