Hey,
I'm not entirely clear - are you required to show history of morbid obesity, or history of failed weight loss attempts? It seems like it might be the second, and if this is the case, you may be ok, depending on the timeframe they want to see. If it is a history of morbid obesity (this was a requirement I had in my UHC claim), I pulled pages from various points in time. Don't forget to get records from places like urgent cares and your GYN if they help support your case.

Just make sure your medical chart clearly shows the ups and downs in the correct timeframe. And, based on what I have read from others, a BMI of 43 should be enough to qualify.

But, as I put in my original post, be sure to get a copy of your contract so you know specifically what you have to show.

Good luck!
Laurie

Hi!

Just curious if any of you have Blue Cross Blue Shield of Mass, and if so, about how long did it take to get approval from them? My surgeon would like to do my surgery in September but I'm still waiting approval.....

Thanks!

I have United Healthcare Choice Plus PPO.

Idk why they require that :/ I've called several times and the reps always tell me it isn't required, however the office coordinator for my WLS surgeons office says it is. So I'm kinda stuck.

I feel ya...I have to somehow get 5 years together. It's going to be hard! In 2011 for example, my BMI dipped way below 40 from a severe unhealthy crash diet. But unfortunately it was during that time that I have any documented Dr. office visits :/

Other than that ONE year, I have always been in the super morbidly obese category.

 

I have Aetna and I am nervous about one part of the clinical bulletin...The 24 months documented weights. I have been obese my entire adult life and in 2009 my doctor advised me to lose weight. Well, I did. But an injury in 2011, caused me to be unable to workout for a while...you know the rest...Here I am today, I gained it all back plus 13 pounds! In 2011, my bmi was below 40 (37.4 to be exact). I have no comorbidities that I know of (sleep study is next week). I am currently at BMI of 43 or so. Anyone, have this issue? I am gathering weights back to 2006 to show I didn't just become obese lately. Oddly, one of the requirements is that you actually had to try to lose weight and be unsuccessful. *Sigh* This is so frustrating! Any advice is welcome!!!

I am also having surgery with Dr. Macik...I was told to get someone to bump up my 2011 weight...(its 14 pounds low, but I was also hospitalized at the time). No one will do that, seeing as its kind of insurance fraud! We can't send in for approval until 9/5/13 waiting for 90 day program to be complete.