My BMI is 37 and of course BCBS Federal (Virginia) requires 2 co-morbidities for approval under BMI 40. I've long suffered from& am treated for MDD (major depressive disorder). My other CM is GERD, and I have very mild sleep apnea. Has anyone out there with BMI<40 been approved with depression as a main co-morbidity? Most interested in answers from those insured by BCBS Federal. Thanks!

Edited June 16, 201412 yr by peteyrulz

My BMI is 37 and of course BCBS Federal (Virginia) requires 2 co-morbidities for approval under BMI 40. I've long suffered from& am treated for MDD (major depressive disorder). My other CM is GERD, and I have very mild sleep apnea. Has anyone out there with BMI<40 been approved with depression as a main co-morbidity? Most interested in answers from those insured by BCBS Federal. Thanks!

I have bcbs. You will be aproved with sleep apnea. That is why all wls doctors test for it. It is easiest way for approval. Talk to your doc about depression. Some insurance co take that as a negative. I have pmdd. It was not recomended to list as a co-morbity. Always go with what your doc recomends. They are the best advisors with the insurance

companies.

Here is a list of co-morbidities that insurance companies consider. Even family history of some conditions will count toward your likelihood of getting that condition if you do not have the surgery. I hope this helps. I am a retired federal employee with BCBS Federal. My starting BMI was 40.1 and when my packet was submitted, I was approved for surgery with a five day stay, in just two days. (But I called them. The co-ordinator at the bariatric clinic was on vacation, so I had the info before they did.)

Obesity Comorbidities

To follow is a list of comorbidities (additional conditions or diseases) related to obesity which may help you in qualifying for weight loss surgery.

• Family history of heart disease
• Family history of stroke
• Family history of diabetes
• Family history of heart attacks
• Hyperinsulinemia
• Diabetes
• High blood pressure
• Coronary-artery disease
• Hypertension
• Migraines or headaches directly related to obesity or cranial hypertension
• Congestive heart failure
• Neoplasia
• Dyslipidemia
• Anemia
• Gallbladder disease
• Osteoarthritis
• Degenerative arthritis
• Degenerative disc
• Degenerative joint disease
• Recommended joint replacement from specialist
• Accelerated degenerative joint disease
• Asthma
• Repeated pneumonia
• Repeated pleurisy
• Repeated bronchitis
• Lung restriction
• Gastroesophageal reflex (GERD)
• Excess facial & body hair (Hirsutism)
• Rashes
• Chronic skin infections
• Excess sweating
• Frequent yeast infections
• Urinary stress incontinence
• Menstrual irregularity
• Hormonal abnormalities
• Polycystic ovaries
• Infertility
• Carcinoma (breast, colon, uterine cancer)
• sleep apnea
• Pseudotumor cerebri
• Depression
• Psychological/sexual dysfunction
• Social discrimination
• Premature death in the immediate family
  

Miss Mac this is fantastic information, thanks so much! My ticker's in good shape but my Dad had CHF & my brother died suddenly from a heart attack. (and that's when the overeating became OOC!) As morbid as it sounds, this gives me hope.

Thanks again for this info. I called BCBS and the girl read the info from the booklet....ummm, thanks but I can read too!! Lol

Glad to help. I used info such as the fact that my mother died from an abdominal aortic anurysm at the age of 67 (not much older than I am now). She was 5'2" and weighed 320 pounds. My oldest brother died at the age of 47 from a heart attack. He was 6' and weighed 320 pounds. My father had two heart attacks and eventually died of a stroke. I had a stroke myself on 2010, and am so appreciative of the outstanding and rapid care that I got at the hospital.

I am sure most of us in the bariatric community can relate to several conditions on that list. I got it from the website for the National Institute of Health. They indicate that most surgeons and insurance companies use this list for consideration.

• Social discrimination

Interesting. How would one prove that?

BCBS had me do a 6 month supervised diet. They wouldn't take any family history in consideration. It was all on me

Miss Mac this is fantastic information, thanks so much! My ticker's in good shape but my Dad had CHF & my brother died suddenly from a heart attack. (and that's when the overeating became OOC!) As morbid as it sounds, this gives me hope.

Thanks again for this info. I called BCBS and the girl read the info from the booklet....ummm, thanks but I can read too!! Lol

Hi

I have anthem BC/BS of New England

And I was told depression was not a co morbidity or joint pain ( bursitis ).

I'm under 40 (39.1 bmi) and I'm sure I'll be in denial aisle when they call me. I'm still going through though:)

Asthma is not a co-morbidity either because surgery will not " correct or eliminate " the asthma.

Pain I know, I am asthmatic

Hi I have anthem BC/BS of New England And I was told depression was not a co morbidity or joint pain ( bursitis ). I'm under 40 (39.1 bmi) and I'm sure I'll be in denial aisle when they call me. I'm still going through though:)

I have BCBS Federal; I was denied shortly after I originated this thread. I was told GERD is no longer accepted by BCBS, and the co- morbs need to be sleep apnea, HT, diabetes with BMI < 40. I have GERD, depression, joint pain to name a few.

Good Luck! I hope BCBS NE goes your way! I'll keep my fingers crossed for you.

I'm sure they won't. I just asked the director of the program tonight of there was advocacy for me during an appeal to maybe help me out of I get denied, I should say when I get denied.

She said I am so close to the 40 bmi (39.1)

She's going to see what they can do to help me

.

Edited July 23, 201412 yr by butterflybefree

Wow, that's awesome!

Mine said no.

I wish a co-morbidity was joint pain.