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Joint pain/arthritis as comorbidity?

FreeTheSkinny66

By FreeTheSkinny66, in Insurance & Financing

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FreeTheSkinny66    9

FreeTheSkinny66
Posted

Anyone have success with joint pain/arthritis as their comorbitidy for insurance purposes (when BMI is < 40)?

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VSGAnn2014    12,992

VSGAnn2014
Posted

Me, me, me!

My BMI was 39 -- 235 pounds and 5'5".

My three comorbidities were arthritis (knees - severe), lower back pain, and stress incontinence.

FYI, I lost 100 pounds, now weigh 135 pounds, and have canceled my knee replacement surgery. Feel great. :)

No lower back pain, and I haven't bought "pee pads" in 12 months. :)

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FreeTheSkinny66    9

FreeTheSkinny66
Posted (edited)

@@VSGAnn2014 Thank you - you've given me hope! lol I am 5'6" and around 239-241 so I am just shy of the 40 BMI.

I don't have hypertension, diabetes, etc. BUT....had surgery for a torn meniscus almost a year ago and I am hobbling now, and Ortho told me I had to lose weight to take the stress off it, as arthritis in knees will worsen. My low back hurts but I never connected that to my weight - hmmmmm. And my feet and ankles hurt all the time.

I have Anthem BCBS and they require 1 co-morbidity, but they do not spell out what is considered a comorbidity! What insurance did you have?

Fingers crossed!!! :)

Edited by FreeTheSkinny66

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VSGAnn2014    12,992

VSGAnn2014
Posted

@@FreeTheSkinny66 ... you're welcome.

Google is your friend. There are many lists of WLS qualifying comorbidities, including these two:

https://www.nationalbariatriclink.org/comorbidities-insurancequalification.html

http://www.obesitycoverage.com/insurance-and-costs/pre-approval-process/comorbidities

My WLS costs were covered by my Medicare and Medicare supplemental insurance (I had surgery at age 68).

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FreeTheSkinny66    9

FreeTheSkinny66
Posted

Oh, google and I are WELL acquainted, and I have read multiple comorbidity lists from reputable sources. But in the world of insurance, all bets are off and they can be fickle on what they consider "good enough" to be considered as a comorbidity for THEM. (oy!)

For example, sleep apnea is a comorbidity. But my primary carrier says it must be SEVERE sleep apnea to qualify. There are many more examples. Was just looking for some personal experiences to get a "feel".

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Jennjjcac    5

Jennjjcac
Posted

I have BC BS and the did thankfully list the acceptable co-morbidities. One was degenerative joint disease; which I had documented in an X-ray for the back. My PCP said arthritis of any kind was really DJD. I too am under 40 BMI and don't have traditional high BP, cholesterol or diabetes. So the DJD was a huge deal for me. I also have fibromyalgia so I am hoping for less pain after my surgery.

Sent from my iPad using the BariatricPal App

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