Question:
What about this one?

OK. I work for Miami-Dade County. I have AvMed Ins. They have one of those solid exclusions. So, I ahve the choice of a BC/BS. Looked at one of my coworkers BC/BS books where the exclusions are. Also a solid exclusion. So, now I'm looking at another insurance which is Jackson Health Plan(Jackson Memorial Hosptial). This exclusion reads "Obesity and weight reduction treatment, including surgical operations and medicalprocedures for the treatment of morbid obesity, unless determined to be medically necessary by the Health Paln such as intestinal or stomach by-pass surgery and a weight loss program required by the covered person's primary care physician prior to surgery." OK, is this one of the exclusions that you can get away with it. From everything I've read it seems like this is one of the good ones. But what also worrys me is that my BMI is 42.8(probably 43 or higher by the time I hopefully get the surgery). I am 24 YOA, But I don't have any comorbidities. Except for maybe my feet swell after a walk and I have a family history of diabetes and heart disease. Of, course if this doesn't work out I will probably take out a loan. Anyway, please someone let me know what they think if either from experience or just advice. Please, I'm desperate.    — Jessica Hernandez (posted on August 20, 2001)

August 20, 2001
This is good! It means that they'll cover bypass surgery and weight loss prorgams for the morbidly obese as long as those treatments meet their definition of "medically necessary". Most bcbs plans define morbid obesity as 100lbs. over ideal weight.
   — [Anonymous]

August 20, 2001
With a BMI over 40 you should be approved without comorbidities. Good luck.
   — [Anonymous]

August 20, 2001
Hi, Jessica. I am 11 days post op now and my beginning bmi was 44+ and I had no comorbitities. I am now at 41 and counting down lol. So, with your bmi being over 40 with no comorbidities, you should still have no problems. Its the ones whose bmi is less than that, that have problems. I am not insurance tech, but it sounds like you got the right one there!! Good Luck to you!!
   — ncgal

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