Question:
anyone approved i have bmi 37 but have had 3 back surgeries
this year alone and arthritis in legs back..does anyone feel hopeful if i get letters from my pcp and orthopedic surgeon that i will be approved?? — Valerie H. (posted on October 20, 2003)
October 20, 2003
Possibly. I'm sure you know that a BMI of 40 or higher is what the
insurance companies look for, however, they have approved surgery for those
with BMI's between 35 and 40 with co-morbidities and if your back surgeries
can be connected to your weight, and if you have other co-morbidities you
may be able to get it approved. Check you insurance companies policy to
ensure that they do not have an exclusion for WLS...good luck.
— Cindy R.
October 20, 2003
Hi there. I had a spinal fushion when I was 19 years old, and have been
diagnosed with degenerative disc disease. Also recently I was told I am
prediabetic. My BMI is only 34.4, I am 5'10" and weigh 235. I am
having surgery November 18th. My best advice is to get all previous doctors
including PCP, and spinal surgeon to send letters to your insurance. The
wording of my gastric doctor in his letter was also different. Instaed of
wording it as a life threatening condition he worded it stating that it
would be much easier for the surgery to be done now rather then when I am
100 lbs or more overweight and that it was inevitabvle that I would get to
that point so why not correct it now. Good luck on your journey, have
faith. Believe me I thought that I would denied, and about passed out when
I found out I was approved, no hassles.
— Mini Gadget
October 20, 2003
I hope everything works out for you but don't be surprised if BC/BS doesn't
approve you the first time around. They generally look for BMI much
greater than 35 with signicant comorbites such as hypertension, heart
disease, sleep apnea and diabetes. I was denied my first time around.
Working on my second predetermination with a BMI of 38.4 now. I'm praying
that I too will be approved and soon.
— CINDY D.
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