Start here
Where are you in your journey?
Choose the path that fits today. We’ll take you to the most useful discussions.
- GLP-1 medication Zepbound, Wegovy, access, side effects, progress, and support.
- Before surgery Compare procedures, plan ahead, and get honest pre-op answers.
- Post-op Recovery, food stages, symptoms, and support.
- Long-term Regain, labs, habits, and life after the honeymoon.
- Revision Explore revision options, complications, and next steps.
Sleep Apnea (timing of diagnosis)
- Views 564
- Created
- Last Reply
Featured Replies
Archived
This topic is now archived and is closed to further replies.
I'm looking for a second set of eyes to help me decipher my insurance policy/share if they've had similar experiences with their insurance hurdles. Before anyone asks, yes I have called my insurance company to clarify but the woman on the phone seemed a little unsure about the details of timing and that's where I think I might get denied!
I'll link my insurance co's policy here: POLICY
My history: In the past 2 years I've had a BMI between 35 and 40 (however I have been pregnant in that time period). I've had sleep apnea symptoms for probably 10 years but didn't think they were a big deal but now that I'm trying to get approved for VSG I'm going to be tested for sleep apnea.
Questions: In my insurance coverage policy it says "presence of severe obesity (for at least 2 years before surgery)" I know my BMI has been between 35 and 40 but I have been pregnant in that time too, will that count against me since some of the excess weight was from the baby?
"Severe obesity defined as a body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 with at least one clinically significant obesity-related comorbidity." I know I've had the BMI for the past 2 years but I haven't had the diagnosed comorbidity for the two years since I'm yet to be diagnosed. Will the timing matter on that? Will the insurance company need there to have been a comorbidity present in the last 2 years to approve me or will just being diagnosed before sending in for approval be ok?
Edited by casandraonline