Question:
I am 90 pounds overweight and BMI of 36 what are my chances for approval
I have several commorbidites, hypertension, high cholesterol, reflux, removed gall bladder, joint pain, long history of antidepressent use. I have two different insurances so if approval is possible, I do not think I will have much out of pocket expense. Any ideas? — Michele C. (posted on November 29, 2002)
November 29, 2002
Most insurance companies will not consider wls on someone who has a BMI of
under 40, unless the yhave some comorbities! but some companies are just
cheap and greedy! good luck to you! i am fighting with mine now with a bmi
of 64 and with all the comorbidites there are!!!! they still said no to me!
— janetc00
November 29, 2002
Call your insurance company and ask them. It will probably have to be
medically necessary. From what I have read on the insurer section here
many consider medically necessary to be a BMI over 40 or between 35 and 40
with comorbids which you apparently have. I would also suggest going to
the insurer section here and looking up Pacific Care for Colorado. I
briefly looked at there appears to be several entries. When I was starting
the process I emailed a couple of the more recent entries and asked about
their experience with the insurer. There are many variables to the
process. I read as much as I could, picked the surgeon and then started
the process. Best of Luck to you.
— Pat B.
November 30, 2002
HI THERE....WELL, WHEN I FIRST STARTED MY JOURNEY MY BMI WAS BARELY A 35,
BUT I HAVE A BAD ANKLE AND HAVE TO WALK WITH A CANE, SO I WANTED THIS
SURGERY REALLY BAD AND WAS ABLE TO GET MY BMI UP TO A 37.7 WITHIN 6 MONTHS
AND HAD NO PROBLEM DOING IT. MY INSURANCE COMPANY DENIED ME AY FIRST BUT
WITH A 12 PAGE APPEAL LETTER THEY HAD ME APPROVED IN 2 WEEKS AND MY SURGERY
IS SCHEDULED DECEMBER 10, 02. I GEUSS ITS ALL ABOUT THE EFFORT AND HOW YOU
GO ABOUT YOUR WHOLE APPROVAL PROCESS. GOOD LUCK
— Karen W.
November 30, 2002
I have Pacificare of AZ. I had a BMI of 36 with Comorbids..diabetes, sleep
apnea, high BP, high cholesteral, and was approved with the first
submission by my surgeons office. Good Luck.
— Diane R.
December 1, 2002
Hate to say this out loud, I had to gain 8 pounds to meet the 40 mark. But
I did it. I hate until I thought I wasn't going to be able to eat anymore.
Went to the doctor and guess what, They measured me a tad shorter than
what I had measured at my work. I wasn't going to argue with them.
; )
— Sherry C.
December 1, 2002
Call your insurance company - you must meet their requirements for
coverage. OR perhaps you are self pay? Then I guess you just need to find
a surgeon.
— Marianne K.
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