Officially DENIED by Ins.

[cat lady 10]

Okay so after 7 months of all the testing required and out of pocket monies....I officially got denied by BCBS. they are saying my BMI is too low at 35.5 for this surgery. I do have high blood pressure and back issues...but they said that the HBP is under control with pills therefore not considered a co morbidity. They are now saying my BMI would have to be 40 or above to get approved. I appealed and got the same denial. My surgeon, Dr. Geiss felt I was a good candidate for this and he even called the ins. medical director without success. Why is it that my HBP is not considered a comorbidity when I hear everyone else on this site is considered for approval. I cannot afford to pay for this surgery so I guess I am finished. I am disappointed to say the least. I am trying to rationalize this by saying maybe this is God's way of telling me not to do this. I must try to do this on my own...AGAIN. I had my date of august 19th so I decided to go on the liquid diet anyway and try to lose on my own. I have to try to exercise and do this for myself. I only wonder why they let me do all the testing and doctors, etc. just to deny me. They knew my BMI and HBP stats from the beginning. It was a waste of time and money also for the ins company. I think they should send it for approval to the ins company earlier...Not after you have your surgery date. Sorry for rambling on but I am discouraged. cat lady:confused::party::smile2::thumbup: Good Luck to all !

[spoiltmom 44]

My insurance said the same thing. They said the blood pressure needed to be un controlled. Mine is controlled with meds and somehow they slipped me right on through anyway. Have you had a sleep study done to check for Sleep Apnea? Have you had your cholesterol and tryglicerides checked? If not you need to. Sleep apnea is a good co morbidity to have.

[honk 780]

I don't know why they gave you a surgery date without insurance approval. Very frustrating. My doctor did not schedule a date until after my last physical/consult with him.

[sourmissg 0]

cat lady, I'm sorry to hear that you was denied by BCBS.

You are the second person that posted today and said

that they were was denied by BCBS. This is what freshstart2010 posted  Today the insurance company finally responded. I was denied. I have been at this since April and had completed the 6 month supervised nutrition and exercise plan. I have H/C, sleep apnea, gout, bladder incontience, and chronic back pains. My BMI is 37.8 and still I am denied by PA BC/BS. I still don't understand why.