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High bmi with no co-morbidities insurance approval?

leliwhoaoh

By leliwhoaoh, in Insurance & Financing

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leliwhoaoh    27

leliwhoaoh
Posted

I'm now half way through my required 6 month medically supervised visits, and as I am getting all the required tests completed I am worried I may not get approved. Although I have a bmi of 43, I have no co-morbidities (no diabetes, high blood pressure, sleep apnea, etc). I'm wondering if anyone out there has been approved with a bmi of 40+ and no co-morbidities? I work at a hospital and have insurance through them, nothing commercial like bcbs or aetna, it's Adventist Healthnet, and they do cover it at 100% after I've met the criteria. I know based on bmi alone, I qualify but I'm worried that they'll find a reason to deny me cause I'm not "unhealthy enough"...i hope i make sense

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Harsha    168

Harsha
Posted

Hey... I had the same exact worry! Besides being overweight, I'm 100% "healthy". I just got my approval yesterday!! My insurance bases it on either 40 + BMI OR less than 40 BMI but have to have I believe three Comorbities.

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peaceout    273

peaceout
Posted (edited)

I had the same fears, even though my surgeon's office kept assuring me that we didn't have to go looking for any co-morbidities if my BMI was over 40.

The one thing I will say, is be careful during the 6-month program and the 1-2 week pre-op diet. My surgeon did warn me that if my BMI dropped below 40 on the morning of surgery, technically my approval could be reversed. I have no idea how true that is, but I can't imagine he'd go out of his way to shorten my liver-shrinking diet just to make sure I stayed above 40 if it wasn't a real concern he had.

Edited by WingFan55

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leliwhoaoh    27

leliwhoaoh
Posted

Hey... I had the same exact worry! Besides being overweight, I'm 100% "healthy". I just got my approval yesterday!! My insurance bases it on either 40 + BMI OR less than 40 BMI but have to have I believe three Comorbities.

Omg that's great! Definitely makes me feel better about my situation. Congrats on the approval btw! Got a date?

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Harsha    168

Harsha
Posted

They are calling me tomorrow to schedule, she said right now is looking end of June!!

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leliwhoaoh    27

leliwhoaoh
Posted

I had the same fears, even though my surgeon's office kept assuring me that we didn't have to go looking for any co-morbidities if my BMI was over 40.

The one thing I will say, is be careful during the 6-month program and the 1-2 week pre-op diet. My surgeon did warn me that if my BMI dropped below 40 on the morning of surgery, technically my approval could be reversed. I have no idea how true that is, but I can't imagine he'd go out of his way to shorten my liver-shrinking diet just to make sure I stayed above 40 if it wasn't a real concern he had.

Yeah my doctors office made sure that I understood, if my weight gets me under a 40 bmi, i can kiss the thought of surgery goodbye!

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leliwhoaoh    27

leliwhoaoh
Posted

They are calling me tomorrow to schedule, she said right now is looking end of June!!

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That's awesome! A month flies by real fast!

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Harsha    168

Harsha
Posted

I hope so!!!!

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reree6898    1,164

reree6898
Posted

I was high BMI and had no health issues and was approved within a few days of submitting to my insurance.

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Womanvsmirror    314

Womanvsmirror
Posted

after my last weigh before submitting to the insurance company I was at exactly 41.8 and was told to hold steady. I was approved with my only medical issue being my bmi. my pre op diet is she for Breakfast and lunch sensible meal and 2 low fat high Protein Snacks. The goal is to stay above 40 until after surgery, sadly ive gained 2 lbs but im thinking its Water weight sd june 1

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leliwhoaoh    27

leliwhoaoh
Posted

Definitely puts my mind at ease, thanks ladies!

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cindyw41    761

cindyw41
Posted

Even with several co morbs I had to watch my BMI during the 6 months supervised diet. Pretty much had to maintain. I ended up losing 8lbs but that still kept me in the game. It's a shame we have to play their game.

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leliwhoaoh    27

leliwhoaoh
Posted

Even with several co morbs I had to watch my BMI during the 6 months supervised diet. Pretty much had to maintain. I ended up losing 8lbs but that still kept me in the game. It's a shame we have to play their game.

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It kind of does suck, its like you have to be careful not to loose too much weight that you dont qualify, but you need to loose some weight to show motivation...

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