IMR-Insurance help!

Orange Coast Memorial in Fountain Valley, CA told me about this site. I'm trying to get approved for the lap band right now. My insurance (blue cross hmo) already refused me 2 months ago for the surgery because my BMI is 38.8 . They only cover the lap band if you have a BMI of 40 & higher or 35 & up plus a life threatening illness such as sleep apnea or diabetes. I went through the appeal process a month ago only to be refused again! Now I'm in the process of filing for an independent medical review. It feels like they want me to get sick or gain weight before they will approve me. SOOOO frustrating!!! Geeze 38.8 is so close to 40 as it is and this isn't even the most I have ever weighed. I was just wondering has anyone else been through this process, and what was the outcome? Thanks!
-Lauren


P.S. Sorry if you have already read this on another message board, I was told I'd get a better outcome by posting on different boards.

I have bluecross ppo and to was deinied my bmi was 39.1 go figure.So I appealed and lost.So I i hope all goes well for youhave started allover again now my bmi is 40.1 we'll see what happens has been along year!!!

 What was the reason your insurance denied you? Your insurance should have to follow NIH guidelines for WLS: BMI of 40 > w/o comorbids and BMI of 35 > with significant comorbids. Do you have any comorbids: high blood pressure, high cholesterol, fatty liver, gestational diabetes? Those are also considered serious comorbids. Do you snore? Are you tired all the time? You may have sleep apnea and will not know unless you get referred for a sleep study. I have info on my page if you are interested, some of it may be helpful in your IMR.