Insurance Coverage Without Co Morbidities?

[Sannah 258]

Hi!

I've just started my process. My insurance covers wls if you have a bmi above 40 or 35-39 with 1 co-morbidity. My bmi is 52-53.

My primary care physician supports/ and thinks I should and would benefit wls surgery.

I am starting all my testing. I do not think I have any co morbidities. I am thankful to not have any complications because of my weight. I see that a lot of people get denied with this co morbidity deal. Do many people get denied with an above 40 bmi and no co-morbidities?

I have Premera bluecross Blueshield.

I would love to hear your experience without co-morbidities.

Evening!

[ladylissa 5]

Hi Im with Cigna I have a bmi of 53 with no co-morbidities. With most insurance with a bmi over 40 u dont have to have them, oh by the way i was approved. not sure about your insurance sorry.

[mkamai 26]

Hi!

I've just started my process. My insurance covers wls if you have a bmi above 40 or 35-39 with 1 co-morbidity. My bmi is 52-53.

My primary care physician supports/ and thinks I should and would benefit wls surgery.

I am starting all my testing. I do not think I have any co morbidities. I am thankful to not have any complications because of my weight. I see that a lot of people get denied with this co morbidity deal. Do many people get denied with an above 40 bmi and no co-morbidities?

I have Premera bluecross Blueshield.

I would love to hear your experience without co-morbidities.

Evening!

I have premera bcbs as well and got approved. Took six months and dont worry the doctors will find some comorbidity to get it past the insurance. With me it was really slight sleep apnea and slightly increased blood pressure. I started at 436. I'm now 376 after only one week post op. I was at 388 on the day of my surgery. It is worth the fight with the insurance

[Sannah 258]

Hi Im with Cigna I have a bmi of 53 with no co-morbidities. With most insurance with a bmi over 40 u dont have to have them' date=' oh by the way i was approved. not sure about your insurance sorry.[/quote']

Hey!! Encouraging news to hear!! Did you have to do any appeals? First time approval?

Evening!

[Sannah 258]

I have premera bcbs as well and got approved. Took six months and dont worry the doctors will find some comorbidity to get it past the insurance. With me it was really slight sleep apnea and slightly increased blood pressure. I started at 436. I'm now 376 after only one week post op. I was at 388 on the day of my surgery. It is worth the fight with the insurance

Was the 6 months for you medically surpervisef weight loss? If so, did you see yor doctor every six months?

Congrats on your success!! Sounds like the weight is coming off nicely. Have any advice to offer?

[Sannah 258]

Hi Im with Cigna I have a bmi of 53 with no co-morbidities. With most insurance with a bmi over 40 u dont have to have them' date=' oh by the way i was approved. not sure about your insurance sorry.[/quote']

Hi!!

Glad to hear of your approval!! :-). My insurance says bmi over 40 without comorbidities. But insurance is tricky!!! So curious if anyone has had particular problems with approval without the comorbidities?

Did you get approval on your first attempt? Any appeals needed?

Have a date?

Thanks so much for sharing!

????

[mkamai 26]

Yes it was medically supervised weight loss I saw the doctor monthly and the weight loss program for me was self driven. Just cut way down on carbs and sugar. Lots of Protein and light exercise

As for postop I don't feel like I am really doing much at this point. Just staying hydrated and getting the Protein shakes down. Stomach aches pretty much all the time but it's only been just over a week.

I'm very happy I went through with the process and really feel like it will work for me long term

[Sannah 258]

Hi!!

Glad to hear of your approval!! :-). My insurance says bmi over 40 without comorbidities. But insurance is tricky!!! So curious if anyone has had particular problems with approval without the comorbidities?

Did you get approval on your first attempt? Any appeals needed?

Have a date?

Thanks so much for sharing!

dde03

Hi!

Sorry for the double reply. I use an ap on my phone for this forum. When I sent the first message it was not sending. So I typed other message.

[Sannah 258]

Yes it was medically supervised weight loss I saw the doctor monthly and the weight loss program for me was self driven. Just cut way down on carbs and sugar. Lots of Protein and light exercise

As for postop I don't feel like I am really doing much at this point. Just staying hydrated and getting the Protein shakes down. Stomach aches pretty much all the time but it's only been just over a week.

I'm very happy I went through with the process and really feel like it will work for me long term

I have completed 2 weigh in at my doctors office. I have schedule my sleep study, and my blood draw.

How did surgery go? Any complications?

A week out for you. Not long eh? On all liquids?

Back to work? Mind if I ask how intense you feel te pain is?

[lacie1221 4]

My BMI is 46, and I have no comorbidities, not even slight ones. I had no problem getting approved the first time - my insurance is Anthem BCBS and I had a date 3 weeks after I submitted my paperwork. Didn't have to do a medically supervised diet either. I hope your process goes as smoothly!

[Sannah 258]

My BMI is 46' date=' and I have no comorbidities, not even slight ones. I had no problem getting approved the first time - my insurance is Anthem BCBS and I had a date 3 weeks after I submitted my paperwork. Didn't have to do a medically supervised diet either. I hope your process goes as smoothly![/quote']

Hi lacie!

So encouraging to hear! Sounds like a good policy you have. I have to complete 6 month supervised weight loss. I have weighed in twice.

Have you had surgery yet? If so, how'd it go?

[lacie1221 4]

Not yet - 3 more weeks! I wish I could make time go by faster.

[Sannah 258]

Not yet - 3 more weeks! I wish I could make time go by faster. <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/smile.png' class='bbc_emoticon' alt='' />

I can only imagine. I would love go hear how things go for you!! Fingers crossed for a smooth surgery (recovery too)!!!

[mkamai 26]

I have completed 2 weigh in at my doctors office. I have schedule my sleep study' date=' and my blood draw.

How did surgery go? Any complications?

A week out for you. Not long eh? On all liquids?

Back to work? Mind if I ask how intense you feel te pain is?[/quote']

Surgery went well. Had a hernia that needed fixing but other than that no problems

I have been on all liquids for the whole time. Managed to eat a bite of chicken salad last night

I'm still off work for another week but I'm a chef and it's pretty strenuous physically so I'm gonna take at least another week. The pain hasn't been bad at all. Occosional discomfort is the best way to describe it

[Mctrisha66 5]

My BMI was just at 40 and I never had one issue with approval (BCBS). I will say I was shocked when I received the first billing from the hospital, which didn't cover the surgeons. Wow. Oh well, it's been 2 weeks since yesterday that I had the surgery and the weight is dropping off!