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co-morbidities?

what does your doctor consider a co-morbidity? Is it 1 or 2 that you need if you're under 40 bmi? is pre-diabetes one? thanks guys

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I think it really depends on your insurance requirements if it's one or two. I only needed one, I had sleep apnea.

I have BCBS and all they needed was a 5 year weight history and 1 co morbidity. For me it was my back and neck. I was in a car accident earlier this year and because it messed me up so bad I was able to claim that as my Co Morbidity. But, I do know pre-diabetes and hypertension are, on my insurance at least, considered. But that's Blue Cross Blue Shield. I am a 39BMI, funny how it's just not big enough to put ya through. :/ good luck!

My date for surgery is August 7th... I wish you all the luck and speedyness that I had. (Started my journey 5/28/14 got my date for 8-7-14)

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it's so silly that you have to be 40 but over 35 is severely obese. I'm in that situation where i'm about 7-10lbs too "small" to hit 40 but i'm pre-diabetic and i shouldn't be gaining anymore weight either. it sucks!!

I know what you mean! It's ridiculous what they consider a qualification. The difference of 7-10lbs when it comes to a BMI, I just don't understand the insurance companies.

I got soooooo lucky with BCBS... They just dropped the 6month weight loss trial. I would have been screwed and had to put it off till next Sept.

Hi! I am in San Antonio. I am just started the process to get sleeved. I went to my pcp and was told I do not meet the criteria because my BMI in only 36.6. ONLY!! Are you kidding me?!? I have been battling my weight since I was 17. I have tried everything including prescription weight loss medications. Does anyone out there know other comorbidities that are covered. I am have a sleep study done to check for sleep apnea. I already have migraines, reflux, and high cholesterol. I am feeling frustrated I didn't get a referral!!

Hi! I am in San Antonio. I am just started the process to get sleeved. I went to my pcp and was told I do not meet the criteria because my BMI in only 36.6. ONLY!! Are you kidding me?!? I have been battling my weight since I was 17. I have tried everything including prescription weight loss medications. Does anyone out there know other comorbidities that are covered. I am have a sleep study done to check for sleep apnea. I already have migraines, reflux, and high cholesterol. I am feeling frustrated I didn't get a referral!!

I had the sleeve done in San Antonio with Dr. Patel. He sent me for an upper GI and found I had a hernia. If you have reflux bad, you prob have one too. Do you have to have a referral from your PCP? Wear a weight belt under a big shirt ... That will increase your BMI. I had a friend do that! BTW Victory Med Cntr was the best!

My husband is military and I have to have the sleeve done at SAMMC. I've read about wearing weight belts and ankle weights, but they just weighed me and it's in my record. I think increasing 10-15 lbs that quick might look suspicious??

I have some of the same questions I have a BMI that low also but I have 2 co morbidities and my PCP said that bariatric surgery would be great for me. I am pre diabetic and high cholesterol. Oh and I have cardiovascular disease. I also have BCBS it does say that you dont need preauthorization for the surgery just to meet the criteria for it. I am very wary and nervous about it. I have my first doc appointment on Mon the 28 july.

hypertension, high cholesterol. insulin resistance, sleep apnea, GERD, fatty liver, polycystic ovarian disease, Barrett's esophagus. these are what i had.

others that can count are : fibromyalgia, cardiomyopathy, osteoporosis, joint disease needing replacement (due to weight strain), back problems, diabetes, pre-diabetes.

it is really all about what your insurance requires. your surgeon or family doctor will be a big advocate in getting you approved, based on the letter that they write to your insurance about WHY you qualify.

Lele@@leelee2728 I also have Blue Cross. Did you have to do a 6 month journal. I haven't met with the surgeon yet as I have to attend a seminar first. However I spoke on the phone with them. I more than qualify. I was just wondering what my wait will be!

  • 2 weeks later...

Hi! I am in San Antonio. I am just started the process to get sleeved. I went to my pcp and was told I do not meet the criteria because my BMI in only 36.6. ONLY!! Are you kidding me?!? I have been battling my weight since I was 17. I have tried everything including prescription weight loss medications. Does anyone out there know other comorbidities that are covered. I am have a sleep study done to check for sleep apnea. I already have migraines, reflux, and high cholesterol. I am feeling frustrated I didn't get a referral!!

First, you need to check IF your insurance covers bariatric surgery. If covered, usually two co-morbidities, which you have mentioned, high cholesterol and sleep apnea should be enough to qualify. Also, you are over a BMI of 35. You need to change your PCP to one that is supportive!

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