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Will this qualify me for surgery?

erica2185

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cbonet    336

cbonet
Posted

You should

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Who'sThere    331

Who'sThere
Posted

It all depends on your insurance

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Cervidae    2,389

Cervidae
Posted

depression and sleep paralysis are not considered co-morbidities of obesity, even though they are obviously linked. Hope it works out for you!

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erica2185    84

erica2185
Posted

Thank you I hope so to..however I did hear if your bmi over 40 then I don't need comorbidity so keeping my fingers crossed☺

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It all depends on your insurance

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I have united healthcare by any chance are you familiar?

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KristenLe    5,979

KristenLe
Posted

I have united healthcare, I have a bmi of 44 ,hypothyroidism, depression as well as sleep paralysis will I get approval?

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Each plan or policy can have different requirements for approval. Your best bet is to call and get specifics for your coverage.

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Djmohr    6,965

Djmohr
Posted

I had United Health Care when I had my surgery 2 years ago. They have strict policies but given you have a BMI over 40 you wont even need comorbitities.

They did require that I use a Bariatric Center Of Excellence and that I had a supervised 6 month diet with that center of excellence.

I had all my ducks in a row and they submitted at 9am in the morning and by 1pm the surgeons office was calling me to schedule because I had been approved. My BMI was 44 and I did have 4 of the 5 comorbitities.

Surgery for me was a piece of cake (pardon...) but it took some getting used to the new eating plan. I have since lost 152lbs and am at a normal healthy weight.

All my comorbitities are gone and some serious illnesses in remission.

I have since begun plastics because I have alot of loose skin and it is exciting in this whole new body.

Best of luck to you!

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BayougirlMrsS    3,933

BayougirlMrsS
Posted

@@erica2185 I had UHC... but, each policy is different. My advice to you is to call the insurance company and ask what are the requirement for WLS and ask if what you have is a qualifying DX. I would make sure you do this .... BEFORE... going to see the WLS...

I knew in advance that i would need a 40 bmi because i had nothing else.... I was just fat. But my BMI was only 38... so i gained 10lbs to get LB surg.

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Go To Topic Listing General Weight Loss Surgery Discussions

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    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
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