Carefirst PPO with BMI of 40

[sunflowergirl 0]

I am new and just getting started and I was wondering if any of you were able to get insurance approval through Carefirst for the sleeve with a BMI of less than 50. I read on a National Carefirst PPO website that it is for patients that are over 50 BMI. I am in Virginia and I understand all policies are different.....just hoping as this is the surgery I want to have. Robin

ps.I may have placed this in the wrong forum...unsure how to move to Insurance Forum

Edited September 14, 2010 by sunflowergirl

[Samma 0]

I am new and just getting started and I was wondering if any of you were able to get insurance approval through Carefirst for the sleeve with a BMI of less than 50. I read on a National Carefirst PPO website that it is for patients that are over 50 BMI. I am in Virginia and I understand all policies are different.....just hoping as this is the surgery I want to have. Robin

ps.I may have placed this in the wrong forum...unsure how to move to Insurance Forum

I also have Carefirst insurance ( the open access and not the PPO) and they do not approve you for surgery without a BMI of 50 or up. For the sleeve that is. My friend and I were doing this together, both of us planning on the sleeve. Insurance would not approve her because of her BMI being too low. They will however approve the band or the bypass. I say go for it. They may make a rule change or if you have other issues they may approve it. It doesn't hurt to try.

[sunflowergirl 0]

Yes I read that And now I am concerned that my BMI is too low. What surgery did your friend opt for? Did/do you have a high BMI? I read somewhere that malabsorbsion issues can get you the sleeve over other choices and I have a history of anemia. I am thinking that my help me get the sleeve. Keeping fingers crossed

Robin

[Samma 0]

Yes I read that And now I am concerned that my BMI is too low. What surgery did your friend opt for? Did/do you have a high BMI? I read somewhere that malabsorbsion issues can get you the sleeve over other choices and I have a history of anemia. I am thinking that my help me get the sleeve. Keeping fingers crossed

Robin

My friend went with the band. She didn't want the malabsorption with the bypass. With your history of anemia you may be able to get an approval. I would think that the bypass could cause problems with your anemia. Keep me informed!