Medical Records/BMI

[kthompson984 0]

I'm in the process of doing the requirements to have the sleeve. I'm just curious of this because I'm the heaviest I have ever been and I'm in the 37-38 BMI range with sleep apnea. My insurance requires 2 years weight history and I was wavering between 210-215 for the most part and at a few points as low as 198 which is not in the BMI range. I'm at 220 now. Has anyone had any experience with this? I'm wondering if they would deny me because I wasn't in this weight range the last 2 years, or is it good that I have shown that I can only lose a little bit and then go back up?

[JamieLogical 8,684]

I wasn't eligible for WLS through my insurance because they require a medical history showing a BMI of 40+ or 35+ with comorbidities for five years. I had lost 90 pounds "on my own" a few years back and my BMI have just crept back up over 40 when I started researching surgery. I felt like I was being punished for at least TRYING to lose the weight and keep it off myself. I ended up being self-pay and going to Mexico for VSG. The alternative was to stay fat and wait nearly 5 more years to be eligible.

[kthompson984 0]

That's what I'm afraid of! What insurance did you have, if you don't mind me asking?

[JamieLogical 8,684]

I have Blue Cross Blue Shield, but every employer plan is different, even within BCBS.

[wannaBthinsoon 1,634]

I have UHC via my employer, and they dropped that requirement a couple years ago. Are you certain that is really a requirement? My bariatric office thought it was a requirement, but I had it confirmed through my Bariatric Resource dept via UHC that, it was dropped as a requirement. Check to be sure.

[kthompson984 0]

I'm not sure if it is or not. I am going back to the surgeon's office Monday and will ask them about it. It was just one of the questions I haven't asked them and thought I'd see if anyone had any experience with it. I have been overweight for many years, just not a 35+ BMI.