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Osteoarthritis

I saw my orthopedist today because of terrible knee pain and occasional swelling. I've had knee problems since I was a kid (I've always been overweight), and the knees have only gotten worse with age and excess weight. Anyway, so I went see my doctor to discuss the pain I have every time I try to exercise and every morning when I wake up. Before I could tell him about the pain I was having, he peeped his head into the exam room and asked if I'd had X-rays yet (on this visit). Long story short, he took one look at my X-rays and said that my knees are awful for a 33-year-old and riddled with arthritis. I told him that I was in the process of getting approved for weight loss surgery. He asked me my surgeon's name and went on to dictate a letter into his recorder - stating medical necessity for my surgery. He said that I had osteoarthritis, degenerative joint disease and would likely have to have both knees replaced before age 40 if I don't lose 100 pounds. I knew it was true, but I cried like I hadn't cried in ages when I heard that.

Has anyone been approved with a letter from an orthopedic surgeon stating that type of diagnosis? I have Aetna, a current BMI of 40 and over the last few years my BMI has fluctuated between 37 and 42. I have no other comorbidities. My blood work came back as if I were a healthy 21-year-old!

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  • DUBrookie03
    DUBrookie03

    I don't have Aetna but I had a similar situation. I also had fantastic labs, except for being 135lbs overweight I was the picture of good health. I was approved by United Healthcare on my first attemp

  • laffypatty
    laffypatty

    And by the way, you look AMAZING!

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I don't have Aetna but I had a similar situation. I also had fantastic labs, except for being 135lbs overweight I was the picture of good health. I was approved by United Healthcare on my first attempt with a BMI over 40 but no other co-morbs. Having the letter will probably help you, and as crazy as this sounds, make sure you stay over that 40 BMI mark b/c that is the cutoff for most all insurance. If you're over 40 they will approve frequently but below that they dig and make you jump through more hoops.

Good luck!

  • Author
I don't have Aetna but I had a similar situation. I also had fantastic labs' date=' except for being 135lbs overweight I was the picture of good health. I was approved by United Healthcare on my first attempt with a BMI over 40 but no other co-morbs. Having the letter will probably help you, and as crazy as this sounds, make sure you stay over that 40 BMI mark b/c that is the cutoff for most all insurance. If you're over 40 they will approve frequently but below that they dig and make you jump through more hoops.

Good luck![/quote']

I lost four pounds at my last visit, and it dropped my BMI to 40.3. I was told to hold steady!!

  • Author

And by the way, you look AMAZING!

The sleeve is becoming more and more approved by insurances.

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