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Worried about insurance. Empire blue cross blue shield.

Hello I am new to the forum. I am pretty worried about my insurance covering my surgery. I have Empire BCBS -NY- and I just did my seminar. My first consultation is Wednesday and I am very anxious. I did my first of six doctor visits needed for my insurance and I weighed in at 227 making me just above 40 BMI. My doctor has been very helpful and listed my comorbities as knee pain, high cholesterol, and high blood pressure. I know my weight and comorbities should be enough but I don't know if it matters that although I do have high blood pressure and high cholesterol it's not high enough to the point that I need to take medication. Has anyone had a similar situation where they had comorbities that weren't severe enough for medications? Also I'm 21 years old.

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Here is a link to your health plan requirements: https://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htm

If your BMI is > 40, it doesn't matter about your comorbidities. Maintain your weight and you're fine.

  • Author

Here is a link to your health plan requirements: https://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htmIf your BMI is > 40, it doesn't matter about your comorbidities. Maintain your weight and you're fine.

Thank you for your reply, I get so anxious because it would break my heart to have to wait 6 months just to get denied. Especially because I just hover around 40 BMI :(

Hello I am new to the forum. I am pretty worried about my insurance covering my surgery. I have Empire BCBS -NY- and I just did my seminar. My first consultation is Wednesday and I am very anxious. I did my first of six doctor visits needed for my insurance and I weighed in at 227 making me just above 40 BMI. My doctor has been very helpful and listed my comorbities as knee pain, high cholesterol, and high blood pressure. I know my weight and comorbities should be enough but I don't know if it matters that although I do have high blood pressure and high cholesterol it's not high enough to the point that I need to take medication. Has anyone had a similar situation where they had comorbities that weren't severe enough for medications? Also I'm 21 years old.

I'm going through the SAME thing as you. I do have a different insurance company though. My current BMI is at the lower end of the BMI range that qualifies for coverage. I was worried about having to do the 6 month supervised weight loss because I wasn't sure if the insurance company would pay if I fell out of that BMI range. My dietician told me that if I get close she will help me maintain the weight so I can get coverage.

With all the appointments & test this whole process sort of feels like a part time job. ????

  • Author

Hello I am new to the forum. I am pretty worried about my insurance covering my surgery. I have Empire BCBS -NY- and I just did my seminar. My first consultation is Wednesday and I am very anxious. I did my first of six doctor visits needed for my insurance and I weighed in at 227 making me just above 40 BMI. My doctor has been very helpful and listed my comorbities as knee pain, high cholesterol, and high blood pressure. I know my weight and comorbities should be enough but I don't know if it matters that although I do have high blood pressure and high cholesterol it's not high enough to the point that I need to take medication. Has anyone had a similar situation where they had comorbities that weren't severe enough for medications? Also I'm 21 years old.

I'm going through the SAME thing as you. I do have a different insurance company though. My current BMI is at the lower end of the BMI range that qualifies for coverage. I was worried about having to do the 6 month supervised weight loss because I wasn't sure if the insurance company would pay if I fell out of that BMI range. My dietician told me that if I get close she will help me maintain the weight so I can get coverage.

With all the appointments & test this whole process sort of feels like a part time job. ????

I know what you mean, I try to think of it as I spent most my life over weight I can wait another 6 months but it's hard to not have a little negativity, especially knowing the tricks insurance company's like to play!

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