worried I will be denied

[suez1105 2]

Ok so I started the process a while back and Aetna requires you to submit a 2 year weight history. I only went to the doctors once in January 2009 and my weight was 246. In 2010-11 it has ranged from 260-280. I did not have any other co-morbidities. A few months ago my doctor classified me as high blood pressure but I am not on meds. She also finally ordered blood work and my cholesterol is high as well but again not on meds. They are both high,but not to the point that I need meds yet. Since my weight for 2009 wasn't high enough my BMI was like 37 it has to be a 40 for no other co-morbidities.

Now I was wondering, since I just had my sleep study on Monday and was diagnosed with sleep apnea,will that help, or will it still matter that my weight wasn't high enough in 2009 and now might have to wait for 2012? If they look back, they will see I have always had a weight problem, but like everyone else I tried dieting and would always fluctuate between 240-270 and now at an all time high of 280.

[got2lovedisney 1]

I'm thinking they look at your current weight as the basis for approval. (Veterans please chime in) The fact that you gained weight "should" only strengthen the argument that you need surgery.

Just a thought...I went to my PCP in January because my Gyn ran blood and found my cholesterol was high. PCP said my cholesterol was borderline so I ASKED him to put me on meds (Crestor). I have since been diagnosed with apnea also but I figured it wouldn't hurt to show my cholesterol was enough of a problem to warrant meds.

I'm waiting on approval now so I know how stressful this process can be...but so worth it.

[dreynolds05 10]

Same thing I have going on. We are in that "gray" area. My doctors told me that sleep apnea is a co-morbidity so it will help you out a lot.

[suez1105 2]

Same thing I have going on. We are in that "gray" area. My doctors told me that sleep apnea is a co-morbidity so it will help you out a lot.

I know evryone thought it was weird that I was walking around before my sleep study praying I would have apnea, lol. They just don't get it. I think it will help and thank goodness it was diagnosed, lol. Thanks for the info, I really appreciate it.

[TheSweetesThing84 0]

I'm currently in my 3rd mth of the 6 month nutritional diet, but what I have read is that they look at your weight when you started your physician supervised diet and they base your bmi requirement on that.

[wondering1 103]

I have Aetna also. That 2009 weight is NOT going to hurt you. Have you been submitted for approval?

[suez1105 2]

No, I have not been submitted yet. They say they submit everything after I have had all my tests done. I thought that was a little odd, why should I got through with an upper GI and other tests unless I know for sure if I am getting it done.

[Wheetsin 714]

I can't promise this, but generally (99% of the time) speaking...

Approval is based on your weight at the time that you apply for approval.

Weight histories are to prove that you have a "problem" - a history of being overweight, instead of just being in a funk and you'll drop the weight shortly.

sleep apnea will help if your insurance company requires comorbidities. Mine did not. If comorbidities are required, sleep apnea counts.