Hi guys. I'm in the process of the VSG waiting for the sleep apnea test to send my file to BCBS California to hopefully approve my surgery. I'm so worried because I don't know if I'll get the approval because my bmi is 39 and I'm healthy except I'm pre-diabetic. Any one can tell me if any case like mine got approved. It's torturous to wait without knowing if I'm gonna get approved or not after months of waiting and tons of dr appointments!!

Thanks

You should be fine being on the borderline with a pre-existing condition... but I am not familiar with BCBS.

Thanks a lot. I think my insurance is anthem blue cross

I don't have that ins... but basically that was my only co-morbidity.. some insurances won't approve with that (according to many people here).. but my surgeon said it's all in the wording. For instance "pre-diabetic" looks different than "elevated blood sugars". I had zero issues aside from that and being morbidly obese. The surgeons know what will/will not work and they usually won't waste their time if they know you won't qualify

There is no "BCBS" in California, Blue Cross and Blue Shield are two separate insurance plans. Here is a link to the Anthem Blue Cross medical policy concerning wehght loss surgery: https://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm

Basically, a BMI of 39 without comorbidities doesn't meet criteria. However (and I'm by NO means recommending this), I have seen several cases where a potential candidate went out and gained until their BMI was 40 or above. As an example, the difference for someone my height between a BMI of 39 and one of 40 is 5 lbs.

I hope this helps!