I am 25 years old and have been overweight my entire life. I was in and out of the doctor for my whole life (asthma, pre-diabetes, PCOS, allergies, sleep apnea) up until the age of 19 when my insurance dropped me from my Mom's plan. I didn't get insurance again until last year when I was 24 and still haven't been back to a regular doctor (I was scared to go since it had been so long), I've only been to my gynecologist who is sending my referral to Baptist health for a gastric sleeve surgery and she is really pushing for me to get it.

I'm worried since there is a 5-6 year gap of literally no doctor visits that Anthem BCBS is not going to approve me for surgery for lack of medical history for those 5-6 years. I am 25, 5'6 and weigh 361 pounds (211 pounds overweight, BMI 58). I have PCOS and was diagnosed with pseudo-tumor cerebri at a hospital, but never followed up with doctors about it due to my previous lack of insurance. I'm infertile due to my PCOS and weight which I know is usually something they consider in approval.

Does anyone have any insight to my situation? Seeking advice, encouragement, personal experiences.

Edited April 3, 201511 yr by tiffanymarie6997

I would encourage you to obtain a primary and get a complete workup physical. Between your weight and your comorbidities the only thing I imagine would happen is you would be required to undergo a medically supervised diet for a period of time. If you are interested in having the sleeve done, I would also get a list of doctor's from the insurance company and try to attend seminar and gather information about a few programs. This way you make sure the doctor you choose is one that works for you.

You certainly qualify, given your co-morbidities and BMI. If you had weight issues your entire life, get copies of your medical records from your teenage years to show your history of obesity, even though they are not relevant in terms of the past 5 years. If BCBS initially denies you, your doctor can write a letter of medical necessity, and will have some basis for past history, which is only a part of pre-qualification.

You got this! You deserve this! Be brave. Take a positive step for a healthier you!

Amy

I have Anthem BCBS and did not have to provide previous years of information. Almost all the requirements were handled within a 3 month time frame (blood tests, GI clearance, psych clearance, weigh ins and nutrition visits at my surgeons office, etc).

So hopefully the lack of history will not be an issue for you. Best of luck!