Co-Morbids?? Help!

[bkc951 0]

So I had my 1st consult w/suregon 2 weeks ago. He said there was nothing they could for me and that tricare would deny lapband for me because my bmi is 36/37ish. At that time I did not have any comorbids that I knew of. Sooo.... I made an appt with my pcp and asked her to run some labwork on me so I could make sure I didnt have any issues we did not know about. Well...total cholestrol is good but here are the abnorms:

triglycerides is High 348(norm is 0-149)

HDL cholestrol is low 34

VLDL cholesterol is High at 70

Im also doing a sleep apnea test tonight....

I also called to make another appt w/surgeon &Im waiting for that...can anyone tell me if this bloodwork will qualify me now? If not, theres the sleep apnea test, which they say the results will be ready in 3 days...

I need this procedure, so I can be healthy , Im so unhealthy. Im 29, married&3 kiddos and I want to be around to see them grow up. Im so young to have these issues! Sorry- this is a little vent but I know u all understand how Im feeling. Any advice??

Thank You!

[Lisa1967 0]

If you do have sleep apnea, that should cover it. As for the lab work, I'm not sure if one time of abnormalities will cover it. I know a history will. Do you get regular annual lab work done? I would call your insurance company and ask what the qualifications are and also ask your surgeon. I have found they are all different.

[xavier 153]

sleep apnea may do it but the labs wont. I had none whatsoever so I had to self pay...I know I'm lucky I could scrape up the $ but I would self pay or maybe sing on the street corners to pay for it all again...its the best thing I ever did after 20 years of being obese!

[AprilRevised 0]

What about Mental Health, like depression and anxiety. These are also co morbidities... Good Luck Keep Fighting!!!

[MelindaH 3]

What about Mental Health, like depression and anxiety. These are also co morbidities... Good Luck Keep Fighting!!!

I do not think that mental health issues will help you as far as co-morbidities go with any insurance. I saw my psychologist and because I have had mental health issues in my past, I went through an extensive interview as well as testing and she would not make a decision until consulting with my mental health providers. I had to agree to have continued sessions with each one after my surgery. I was very concerned that I would not not be approved. evem with being stable on medication for several years, I was willing to take the risk because I felt it was in my best interest to be honest with all of them. I am still preop as I have classes to complete and still have some weight to lose.

I hope to have surgery by the end of the year. All the best to you,

Melinda

[Daisylee1 0]

Why did the doctor say no? was the BMi too low? mine is 46. our insurance requires over 40 BMI. do you have to have other stuff wrong with you also or is the weight of 325 and that BMI enough?

[MelindaH 3]

Why did the doctor say no? was the BMi too low? mine is 46. our insurance requires over 40 BMI. do you have to have other stuff wrong with you also or is the weight of 325 and that BMI enough?

Hi, Daisylee

Most, not all, insurances require that there be co-morbidities present if your bmi is between 35-39. I am not sure about you having to have co-morbidities if your BMI is over 40. Most, not all, insurances require some type of dietary counseling, a psych evaluation, a sleep study, lab work, attendance at support groups, classes and any other testing that the surgeon recommends. Every ins is different so it is really best to call the customer service of your ins co and/or website of the ins co. In your case, it could be that your BMI is good enough. All the best to you, Please keep us posted with your progress.

Melinda