kittydream

I'm pre-op, have been going through the process since Feb. I am 19 lbs away from a 40 BMI. After multiple tests to see if I have one of the very specific co-morbidities that my insurance requires, it turns out I do not. I feel like the wind got knocked out of my sails (or whatever that expression is). I am 19 lbs away from not needing a comorbidity. 19 lbs. Has anyone heard of anyone gaining weight in order to meet the insurance requirements? I mean, I've *been* steadily gaining weight over the years, so I know I will get there eventually. Im just tempted to eat more bacon now.

I am RNY Sept 15th!!

Anyone have this insurance? If so, how long did it take for you to get your approval/denial back?

Hi there, started my process Feb 17th. I have a 35 BMI so am req by my insurance to have a co-morbidity. Im getting tested for Sleep Apnea. I told the sleep Dr I saw for the consult that I am getting WLS in August. She looked surprised and I felt she was waiting for me to explain why. (Could just be me over-analyzing). I started w a chiropractor for back/neck pain. I have seen two doctors there so far for two appointments. I told them I was getting WLS hopefully in August. Both had a surprised look on their face. First one said "why?? You're not that big. You need to go gluten free. My wife couldnt lose weight then finally went gluten free blah blah". Next chiro said "really?!? Well... That will help alleviate the pain in your pelvis. But you don't need this surgery do you?? Why are you getting this surgery?" I just feel like saying CLEARLY I am 100 lbs overweight. Yes, I am 5'10 and carry it well but its still there. And so is a disease called FOOD ADDICTION. This is not a matter of me needing to discipline myself with diet and exercise or go gluten free to magically shed 100 pounds and a lifetime of pain, humiliation, feelings of failure after 25+ yrs of "taking responsibility" for my health by trying EVERYTHING. I guess im just disappointed that the doctors didn't seem supportive. Has anyone else been dealing w similar?? Any advice on how to handle people saying "what?!? You don't need surgery!" (The one friend I told responded like that)...

Im pre-op, wear a size 11 shoe. I have noticed stores like Marshalls, TJ Maxx and Ross carry 10, 11, 12. Also, since stores usually just stock up to a 10 I have asked if they can ORDER an 11. Nordstrom will and ship it free to your home.

I have read that some people get denied and have to go appeal with insurance... What makes insurance deny someone? It sounding like some insurances are being very nit picky...

In the 6 month supervised weight loss plan prior to the surgery date, what is insurance "looking for" ? What if I lose weight and am no longer in the proper BMI range? Is that what they're wanting?

I'm about a month and a half into the process, I have BCBS Premera and apparently they're very particular about the insurance requirements. I am 5'10, 253 and am required to have a co-morbidity. The only one I come close to is sleep apnea. My pcp ordered a sleep test for me. If I dont have moderate to severe OBA I will not qualify. If I gained 30 lbs I would not need a co-morbidity. Ugh. Has anyone had to do a sleep study?

@ ambpete - thx for the info! I have been scouring the threads- so much helpful information and support. Gosh, so not only do we have to be diagnosed with sleep apnea but we also have to be monitored with a cpap and show progress?? Is that what you are finding common with the insurance requirements?