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Qualifying comorbidities....seriously?!?



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I just found the National Institute of Health's list of WLS qualifying comorbidities. One of the conditions listed is "premature death". Exactly how many medical experts did the government hire to come up with this list, anyways?

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Well if "premature death" is your comorbidity than you are the insurance favorite Customer! Automatic approval! Then into the trash!

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But it wouldn't surprise me if they STILL wanted you to attend all your nut and psych visits and complete the 6 month supervised diet before submitting the paperwork. ????

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I am an RN Case Manager for the 2nd largest insurance company in the US. Insurance companies have policy they must follow. Nutritionist and psych clearance is mandatory. They are going to spend a lot of money on this surgery and want to make sure you can be successful and remain successful for a lifetime! Typically a BMI of 40 or higher does not require any co morbs but a bmi of 35 to 39 does ie diabetes, sleep apnea, cardiac, etc. I believe Aetna requires a supervised 6 month diet.

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I am an RN Case Manager for the 2nd largest insurance company in the US. Insurance companies have policy they must follow. Nutritionist and psych clearance is mandatory. They are going to spend a lot of money on this surgery and want to make sure you can be successful and remain successful for a lifetime! Typically a BMI of 40 or higher does not require any co morbs but a bmi of 35 to 39 does ie diabetes, sleep apnea, cardiac, etc. I believe Aetna requires a supervised 6 month diet.

I get that, but who's performing surgery on a corpse?

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I am an RN Case Manager for the 2nd largest insurance company in the US. Insurance companies have policy they must follow. Nutritionist and psych clearance is mandatory. They are going to spend a lot of money on this surgery and want to make sure you can be successful and remain successful for a lifetime! Typically a BMI of 40 or higher does not require any co morbs but a bmi of 35 to 39 does ie diabetes, sleep apnea, cardiac, etc. I believe Aetna requires a supervised 6 month diet.

.

????❓❗️

Edited by Kindle

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I misread the question. Please forgive me! Could do with a little less sarcasm. Thought we were all here for support?

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I misread the question. Please forgive me! Could do with a little less sarcasm. Thought we were all here for support?

"Ditto"

My Dr. flat out told me if I did not loose weight, I would surely die...and Soon!

That was when I was 57, having already lost both my Brother and sister to a premature slow and agonizing death primarily stemming from obesity. Unless you like infections, blindness, amputations and dialysis 3 times a week.

Not a joking matter.....Seriously!

Edited by B-52

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I thought it was evident that the post was in jest. Premature death as a qualifier for surgery would be a bit of an oxymoron, no? It wasn't laughing at any particular poster.

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Lol!! This thread! Why so serious?? @@Kindle No more funnies!! : )-ha!

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I laughed too, but then realized that it actually means Risk for premature death, but it sure was funny reading it as having to die before getting approved for WLS.

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Actually the website I was on listed "premature death", not "risk of premature death". But you're right @@Elode, I will keep my funnies to myself from now on. But it's nice to know at least somebody got it.

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@@Kindle keep it coming! Brought back memories of extremely stressful pre-surgery weigh-ins because my insurance company had one requirement only: BMI of 40. I was nearly 250 but at my height not fat enough for WLS unless I carried hand weights in my pockets, which I did. The stress got me up to 252 on my own, lol.

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I used that list from the National Institute of Health as well when working with my team to determine qualifying co-morbdities. I was told to include anything on that list that caused complications for anyone I was related to. So, we added my mother's premature death at the age of 67 (only four years older than I am now). She was 5'2" and weighed 320 when she died of an Abdominal Aortic Aneurysm - a complication of her own obesity. We included my dad's two heart attacks, and my brother's heart attack and premature death at the age of 47 (he weighed around 420 pounds and the funeral was delayed so that a double-sized coffin could be built).

Here is the list if anyone wants to use it for inspiration:

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

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Thanks miss Mac! That was the exact list I saw but they didn't have the "in the immediate family" part on the last line.

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