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I just went for my endoscopy yesterday, I now only have two more nutrition appointments and I will get my surgery date. I am so excited but a little nervous that my insurance will not cover it because I have no major medical concerns, my bmi is just really high. I have united health care and their requirements are a bmi of 40 and over to be covered but you never can tell. Has anyone else not had any medical issues and were covered by insurance just for a high bmi?

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I didn't have medical issues either.. like you I was over 40 bmi I qualified. My ins covered everything. I have Kaiser Permanente Insurance. Best Wishes Tina

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so far when i called my insurance company they said everything was 100% covered. I have magnacare. I dont have any "traditional comorbidities" but i do suffer from Migraines and urinary incontinence.

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Ditto - high BMI, no co-morbidities. Covered.

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I had no health issues just a high BMI and everything was covered. I only had to pay the hospital co-pay. I have Amerihealth Insurance. Good Luck

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Thank you all so much. All of your words are very re-assuring. I am so so excited. For the most part I am a very positive person, the insurance issue just rests in te back of my mind because I tried to get my insurance to cover a weight loss pill and they wouldn't so I was a bit skeptical as to why they would cover a 15 thousand dollar operation. To hear this feedback gives me hope

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I didn't have medical issues either.. like you I was over 40 bmi I qualified. My ins covered everything. I have Kaiser Permanente Insurance. Best Wishes Tina

Hi my name is suzy and I was given the option for the gastric sleeve by my doctor, I have kaiser and I'm in southern Cali. Can you tell me what you need to get approved and if you paid anything out of pocket?

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Hi Suzy. I'm not too sure how your insurance works but I myself am still waiting for approval. I haven't had to pay for anything out of pocket and my medical has covered all the test required prior the surgery. I have two more nutrition appointments to go and I am golden for a date. I'm so excited. I've never wanted anything mor for myself in my entire life.

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Missy, I am keeping my fingers crossed for you. Now that they have officially acknowledged obesity as a disease, I think the approval process based on high BMI alone is going through much better now.

Sent from my iPad using VST

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Susan thank you so much. My surgeon is also confident that the medical insurance will covert the surgery and she says if not she will push harder to get it because I definitely qualify with a bmi of 50.

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Same here Bmi high but no medical problems all testing clear.Insurance covers everything.

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Do you mind me asking which insurance plan you have? How was surgery for you? How much weight have you lost?

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Susan thank you so much. My surgeon is also confident that the medical insurance will covert the surgery and she says if not she will push harder to get it because I definitely qualify with a bmi of 50.

Hope they cover you!!!! I also just had a high bmi of 58. I live in Massachusetts and have bc/bs. I was approved right away. I just have to pay deductible and copays. I'm scheduled for surgery August 12th. Good luck. Try having your doctor write a letter of medical necessity.

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I'm going to stop worrying and put it in gods hands. I want this so badly. I have my fingers crossed. Where about in Massachusetts are you? So happy you're covered! You start your amazing journey very soon and i wish you the best!!

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Also my doctor wrote about hypertension and diabetes runnin in my family in hoping that's a good enough reason for me not to mention my bmi. I did call te insurance company myself this am and they said that with the bmi and drs note I should be fine

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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
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      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • ChunkCat

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