BCBS of IL

[Kbug68 4]

Hello everyone! I am new here I'm currently battling with BCBS of IL. I had my surgical consultation Sept 13th and had a BMI of 39.93 on that day. My plan denied as my BMI wasn't 40 - one more pound and it would have been 40! Anything under 40 requires 2 co-morbid conditions which I don't have. I am now going in for a 2nd consult with him October 25th to be weighed again so he can submit an appeal. He suggested I wait a bit so it wouldn't seem as though I was gaining weight on purpose, however we are talking about ONE POUND here. Weight fluctuates daily, weekly....etc. I have now gained 5 lbs in 4 weeks - is that bad? Should I try to make it more like 1-3 lbs? This is an awful situation to be in.

[Fluffnomore 1,235]

I hate to say this, but I was in your same boat. I let myself gain a couple of pounds right before my last appointment. I just squeaked over 40 and was immediately accepted.

Just go in and do it. Your doctor can make the argument that you were within a normal fluctuation. Do you have the higher weight documented on any other doctor visit (the surgeon or otherwise?)

[Fluffnomore 1,235]

Also BCBS IL, by the way.

[Kbug68 4]

Approved!! I went in, was re-weighed and he resubmitted. I was approved about a week later. Excited but nervous too! Surgery is scheduled December 4th, pre-op Nov 20th.

[Fluffnomore 1,235]

Oh, good! Afterward I realized this was an older post. But I am so glad for you!