Borderline BMI - a waste of time and you still pay?

[NewSho 20]

Mary,

I don't know but I do know that the Harvard Pilgrim program was voted one of the best insurance plans in the country due to patient satisfaction (The nearby Tufts plan was voted the best overall in the U.S.)

No I don't work for Harvard Pilgrim but I know people have said that they are fair to deal with. sleep apnea is a very serious co-morb, and paired with hypertension and your other medical issues, then you should persue approval with all your strength.

Good Luck to you!

[lotsofkids 0]

Even with a BMI of only 35.....my insurance approved me and I had my surgery on May 23rd, 2006

I had sleep apnea

hypothyroid

starting to get hypertensive

and a fatty liver

Of course....all the copays and deductibles will not be applied to my annual maximums.....so I will be probably paying between $4000 to $5000 for my portion.....but I was thrilled to be accepted...and quite surprised!

good luck and hang in there!

diane

[ladysplenda 1]

My BMI was 35 Im in a size 14 right now.

[ladysplenda 1]

Both my daughter and I had to prove that being on a diet worked but not well. No major weight loss.We had to go a year.Show that we knew our correct portion sizes. Write down what we we in a journal. They want you to make a serious effort on your own before they invest the money on you. They think If you give up that easy you will not do well with surgery.

[Constance 0]

I have been on the supervised diet for 5 months now. I am so sick of being so heavy. I am now at a BMI of 40 - terrific, right? Yeah, well now I come to find out Cigna requires one year at a 40 BMI - or 39 and under with co-morbidities. And they are talking serious, like Type 2 diabetes and pulmonary hypertension. I might as well go another month, but I have this sneaking suspicion I won't get coverage. It just sucks that I have to wait to find out.

[peaches9 3]

I have Harvard Pilgram and I have not started the battle yet. I am a mere 33 BMI. I have sleep apnea that is so bad that I may be forced to do that surgery--which seems far worse than this one. I had a mini stroke 6 months ago. I have high BP and my feet hurt, really hurt, all the time. Do I have a prayer of getting it covered??

I have been on the supervised diet for 5 months now. I am so sick of being so heavy. I am now at a BMI of 40 - terrific, right? Yeah, well now I come to find out Cigna requires one year at a 40 BMI - or 39 and under with co-morbidities. And they are talking serious, like Type 2 diabetes and pulmonary hypertension. I might as well go another month, but I have this sneaking suspicion I won't get coverage. It just sucks that I have to wait to find out.

I totally sympathize with you. When Insurance companies have OUR lives in the balance it is very frustrating indeed.

If you were able to Self pay (like I did in Canada) you would be surprised where you could find the money. I am taking my loan over 10 yrs and my payment is $169 per month. It is coming off my grocery budget.

When I add up all the times I went thru the drive thru for donuts, coffee, MacDonalds.... yada,yada,yada.. plus now that I am banded I am eating less than HALF the food I did before.

Now lets look at it another way, all the stress of fighting with the ins. co. what's that doing to your B/P?

Your health is worth every penny you put into it.

Whatever you decide, I hope your journey is successful.