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Is obesity a medical condition.....

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DebDUtah

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So here it is only one more visit and my supervised diet will be over, all my lab work and required doctors appointments and tests have been completed. I have to say I have not tried to lose weight during this supervised time (although I have lost a few pounds), but I have not gone wild either with food funerals as I have read others have. I have been swimming, walking and drinking lots of water to get used to it, but I am not dropping weight. I know that it is no surprise to me that I have not lost, but now I am worried that my insurance will deny me. Now I know that they cannot deny me based on my performance during this six month supervised diet, but they could deny me due to medical necessity. Ok this "medical necessity" scares me, as I have no medical condition warranting this surgery, unless obesity is a medical condition. Is obesity a medical condition? I have no co-morbidities, I am one of those lucky (or in this case unlucky) individuals who does not have any co-morbidities or required medication (I don't even take multi-vitamins) that would fast track me to approval. So now, here I sit, so close and scared to death I will not be approved. I guess if I expect the worst and hope for the best that I cannot be disappointed, right? wrong!! I have always be so glad I am "healthy" and now this may be my downfall. My BMI is over 50, yeah I never knew it could go that high either, but it is setting in that I could be denied. I went into this not even thinking that but now basically I have jumped thru every hoop and now my future lies in someone's "opinion and interpretation" of my chart compared to insurance guidelines and coveage. I am so not looking forward to this last leg but am taking it one day at a time.

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My insurance required a BMI of 40 or greater for approval or, a BMI between 35-40 with two co morbidities.

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My insurance required the same as cbd up there. I was in the same boat as you, no comorbidities just obesity. My BMI was 53.6 when I started to lose before my preop diet, now after losing for a month prior to my preop diet, the preop diet and 10 weeks since surgery, I'm down almost 75 pounds. If your BMI is over 50, you should be approved with no problems. I even heard back from my insurance company within just a couple of days.

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Morbid Obesity is definatly a medical condition. If you don't have heart disease, high cholesteral or osteo arthritus and sleep apnea......you soon will and any insurance company that denies you now are stupid and I would definaletly appeal. Your BMI is high enough that you should have no problem. Be blessed that you have no co-morbity issues. Good luck/

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