Question:
BMI BELOW 40...anyone approved?

Has anyone with BCBS Preferred Elect PPO in MA been approved with a BMI BELOW 40? I have a BMI of 37 (234 pounds, 5 foot 6) with Cholesterol at 234, borderline High Blood Pressure, and a Genetic Marker for Future Heart disease...Any thoughts? I'm literally getting fatter by the day (I've gained 20 pounds just since my hysterectomy in September...and I WORK OUT!) and I'm so afraid I'm going to end up with diabetes or a heart attack if I don't get this surgery.... Annie in Marshfield, MA    — Annie F. (posted on March 1, 2003)

March 1, 2003
Hi Annie, I know how you feel. My BMI is exactly 40. At first, I thought it was under that, but come to find out, my scale was 7 lbs. light, so I am a 40. Now, everyone's insurance co. varies, I have BC/BS PPO of Rhode Island. I called them and asked them their requirements. I urge you to do the same thing. They told me: 1. BMI 35-40 If you have a lower BMI, they want you to have co-morbidities 2. Proof of failed attempts to lose weight under a Doctors supervision, (this does not have to include drugs by the way) 3. Proof that you don't have endocrine or thyroid problems that may have contributed to your weight gain. 4. Been obese for at least 5 years. Just obese, not necessarily morbidly obese. So, call your insurance co. and ask them! Good Luck to You. I am still pre-op and waiting for my initial consultation with my surgeon.
   — Michele B.

March 1, 2003
HI! ANNIE I HAD A BMI OF 39 HAD ACID REFLUX,DEPRESSION,BACKPAIN,FAMILY HISTORY OF DIABETIES,HEART PROBLEMS. I WAS APPROVED BY BC/BS PPO! GOOD LUCK AND DONT GIVE UP MAKE SURE YOU DOUBLE UP ON PAPER WORK! ALL YOUR DIETS AND DIET PILLS YOU TRIED!!
   — Jenny L.

March 1, 2003
Annie, goto www.BCBSMA.com and enter gastric bypass in the search field this will bring some info on what bcbs has for requirements. copy and paste this and it will bring you there. http://www.bcbsma.com/common/en_US/medical_policies/379.htm#definitions I have bcbs hmoblue and a bmi of 39 with not to many comorbs and my doc said I should have no problem.
   — Kim R.

March 2, 2003
I have BCBS Federal Plan PPO in NJ. I was 5'7 240, my BMI was about 38 or 39 with no co-morbids and I was approved. 11 months out and I am down 100lbs to 140.
   — Michell C.

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