Comorbidities

[LoriW188 14]

So I am tentatively scheduled for surgery 9/20. I have a bunch of appointments to get clearance from the actual surgeon's office, and some for the insurance for approval. Right now, or shall I say at my first appt my BMI was at 38 - when i got home and used my scale my BMI was 40 (Go figure!). Well, the insurance requires a BMI of 40 or greater, or a BMI of 35-39 with a comorbidity listed. I went to my primary dr Friday to get everything checked and my former hypertension issue wasn't apparent. I'm at a loss bc I don't know what else they will look for as a comorbidity and worried now that I'm "not fat enough" for insurance to cover.

Two years ago when I went for my initial consultation, I had high blood pressure, insomnia, and depression listed as my comorbities but I didn't want to be medicated so my Dr can no longer use those. Any suggestions from anyone?

[SusieSunshine 68]

Can you just go in and re-Weigh? Maybe wear heavy clothes?

[Winteranne 5]

I was in the same boat...BMI of 38 and no other comorbidities. And my insurance also required a BMI of 40 or more. This may be terrible, but I gained 10-15 pounds to push my BMI up and to get approved. It worked I got approved and I'm having surgery tomorrow.

Good Luck with everything

[LoriW188 14]

I was thinking of that! Lol, but the surgeon kinds gave me a "Don't you dare!" look when I said that. Did you have to wait a bit to send approval? I don't know what weight they submit to the insurance.

[Winteranne 5]

I'll be honest with you I made sure I had a BMI of 40 plus when I actually started my process. My process meant 3 mos of supervised nutritionist and reg dr appointments. They didn't submit my paperwork for approval until after the 3 mos and I was approved in 48hours. I have federal BC/BS. Insurance also wanted 5 years of weight history which I was freaked out about b/c my BMI over the last 5 years was always between 35-38, but evidently that didn't matter. There was no way I could afford self-pay.

[LoriW188 14]

Oh, I'm feeling like maybe I should've waited and went when my BMI was up a little. I can't self-pay either. I guess I have to wait and see!

[NWgirl 574]

I also gained about 10 pounds to push myself above the 40 BMI. Most home scales are not as accurate as the Dr's office (although they seem to show the opposite problem of weighing less than a Dr scale), so this may also be the issue.

If you're really worried about it, call the Dr's office and ask about the weight and find if they use the first weight or if they use the highest before submitting to insurance.