37.1 bmi- chances?

[utkscvol1 125]

My Bmi is currently 37.1. I have horizon bcbs. According to the medical policy I printed from my plan in order to qualify with a Bmi between 35-40 I have to have atleast one comirbidity from about 15 listed. Out of the list I have 5. I have one more monthly supervised visit that they require left- I go in less than 2 weeks for my nutrition consultant and physchological eval. Then 2 days after for my last monthly visit. Just wonder if I will have a hard time with getting approved with the 5 comirbidities and Bmi under 40

[mrsto 2,925]

Based on what your insurance policy states, it sounds like you fall into the criteria for surgery. Your doctor's office should have already called for approval, before they started doing all the pre-stuff. They should be able to advise you on this. My doctor's office called my insurance company BEFORE they setup all my appointments.

[utkscvol1 125]

The only appointment they have set up was for the nutrition and pschy eval. I was told they won't schedule upper gi and other testing until insurance approves. I really haven't had much contact with them other than my consultant. This is supposed to be the best center around and I have had several physicians tell me they have not heard any bad stories from this dr. I guess I'm just getting anxious as time gets closer. Trying to make sure I have everything taken care of for hopefully an approval first time thru.

[mrsto 2,925]

Good luck.... It sounds like it shouldn't be an issue.

[brianb 81]

Agree with others. Most insurance companies would approve and probably want you to have the surgery. Of course, there are still a few that are a pain, but your chances are good.

[twflorida 1]

I started with a BMI of 38%. I also have BCBS - the federal Employee program.they required a 3 month physician supervised weight loss program. I followed all of their instructions, helped make sure that the surgeons office got everything that they needed or wanted from my other docs. Luckily the hospital system here has a nurse in charge of the program that helps walk you thru the system - and knowing what to expect every step of the way..

BCBS approved me with only one co-morbidty factor - but a REALLY shitty family heart history. And my co-morbidity factor was high cholesterol.

I had my surgery 5-21.

[It'sTime 82]

I got approved with a BMI under 40 and one co-morbidity (sleep apnea).

[utkscvol1 125]

I was approved:) surgery is june13. They took forever to approve. I was beginning to get anxious. Looking forward to it:)