Nora82

Yes absolutely. They just look for the year, month doesn't matter. You just need one recorded weight from each year.

I would definitely get a note from your doctor who is treating your lymphedema to send in with your preauthorization that states that the recent weight gain was due to this issue. If they mark the date that you started having issues with it and coincides with the time you started gaining weight it will definitely help.

You just have to be at the same weight or lower than your starting weight. Even if your records show you gained a pound or 2 during your monitored it the beginning and end weight that matter.

If your primary does deny it your secondary will cover it all except your out of pocket. Hopefully your primary will cover it but if not you still have hope ????

I have!!! Best thing that ever happened to me. I actually worked for my surgeon before 2 years before I was brave enough. Once I had it I wished I would've done it 2 years earlier.

Nope that won't be an issue at all. As long as your doctor puts in his note that you discussed weight loss.

Fluctuation is generally ok and insurance companies take into account diet attempts when looking at your overall BMI. Just make sure your weight at the end of the 6 months is equal too or less than your starting weight. Some insurance companies will deny if you gain weight, justifying the denial by saying your not ready to be dedicated to trying.

He is amazing! You will love him!! You couldn't be in better hands. We sure do miss him here.

The surgeon that I have worked for the last 3 years and who did my sleeve in April has relocated to Erie, PA. Dr Anthony K Davis. If you're looking for a GREAT surgeon you won't be disappointed.

I work as an insurance coordinator and we just had a patient who missed one month weigh in. She still got approved. The best thing to do is get a letter from PCP as to why you were unable to weigh in that month, that it was not because you just didn't go that month. Insurance companies are usually lenient on that if you have documentation as to why you missed a month. For our patient I sent in her paperwork, the insurance called to ask about the missed month, I explained to them why she missed a month and they approved.

You have to just be at or below your initial weight. You don't have to lose but you can't gain.

Most insurance companies require that you have the same weight or lose weight during your monitored. As long as your at or below your original weight by the end of the 6 months you should be fine.

Talk to your HR. In most cases your employer can give you an administrative override to cover the surgery specifically for you. You will most likely have to present all the benefits to the company for you having this surgery (increased productivity, lower health care costs after surgery, etc.). I am an insurance coordinator and am currently working with one of our patients HRs. They've never had a request for an override but they are seriously considering it.

With Cigna I would suggest seeing your doctor for weight loss for 4 consecutive months. They consider your first visit as the beginning of the 89 days and the last visit as the end of the 89 days. If you see the doctor for only 3 months they only count it as 60 days.

If your having surgery in 2016 you just need one weight from 2014 and one from 2015 that's shows your BMI over 35. Even if you had a BMI under 35 for most of the year if they can find one in the entire year that shows over 35 you're good.