Please help, I just got a denial letter from my surgeons office saying that I didn't have 2 comorbids that have not responded to maximum medical management that are generally expected to be reversed or improved by bariatric treatment!!!!

My BMI is 35.6 my comorbids are a high cholesterol of 254 and sleep apnea. I have had high cholesterol for years with no medication and I have had a sleep study done years ago but I dont use a cpap. Any ideas on how to appeal this decision?? My surgeon's office submitted all other requirements. I have tried other weight loss methods like weight watchers, used phen phen, atkins diet, dexatrim, slim fast, scarsdale medical diet, grapefruit diet, etc..Any info would help... I am desperate !!! I am scheduled for surgery on November 4th supposedly. Very upset and can't stop crying here..

Skalleywag - I've been thinking of you - just checking in on you to see how you're doing. Has your doctor offered anything in the way of a plan forward?

Doing ok I guess. Gathering all my paperwork and working on a appeal letter. I have been doing research on my comorbidities and have found some very interesting information. I have found I am not really a candidate for cholesterol medication since I have had a complete hysterectomy and am in menopause. Studies show women put on meds have a 71% chance of getting type 2 diabetes ! and that my LDL is only at 174 which is high but not high enough to recommend meds. So I am putting all this in my appeal letter and we will see what happens. Thanks for thinking of me

Wow. - I didn't know that statins were contraindicated in post menopausal women. I am definitely asking my PCP about that as he reduced mine but didn't eliminate it. I am glad you are working on an appeal. It really is worth it for your long term health and well being. I truly wish you the best.

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I too have BC/BS of Illinois. I was denied the night before my surgery. My Dr.s office called them multiple times and they never called him back, so the surgery was cancelled. But the third day the ins. Dr. did call and when they talked the ins. agreed to pay. So now it's done and I am so thankful! Keep pushing!