Grrrr. This Part Is So Stressful!

[Jessica9190 127]

Ok, I have BCBS Federal so it's really a good insurance to have. It requires 3 months diet with NUT BMI with 35-40 with comorbidities or BMI over 40. My BMI is over 40 and I have a month and a half to go on the NUT thing. My problem is they also have to submit a two year history from my regular doctor showing a BMI OVER 40 I'm one of those people who bounce all over the place and lose and gain weight constantly. Last December I was 180 now I'm 250. I don't know if I was over 40 during the last two years when I went to doctor. I am waiting on my records from my PCP. Anyone else experience this? Trouble with the two year history? How strict is the insurance company?

[Jessica9190 127]

Does anyone know how this works?

Should I be freaking out?

[jillb 45]

I have bcbs and my bmi was 37 when I applied. I do have sleep apnea, hypertension and a couple other problems. BCBS did not call for my records. I had no problem getting approved...

Good luck to you!

[notmeanymore 629]

Hi Jessica,

I have BCBS Federal and was freaking out about the exact same thing. My PCP actually LOST my records for 2011 so I had to submit records from 2008 and 2012. In 2008 I was lighter and only had a BMI of 38. Anyway, I was so worried (even cried) that I wouldnt get approved because of the gap in dates and the fact that I couldnt prove I was this big for the past 2 years. But I got approved me within 3 days of being submitted.

I also had to do the 3 month supervised diet. I just cleared my pulmonology exam last week and waiting (not very patiently) for my date. It should be the beginning of December. Nice way to start the New Year out.

Good luck, keep me posted as to what the outcome is. Remember, the insurance liasion at the surgeons office WANTS you to be scheduled, thats what they are in business for. They have seen all kinds of scenerios and probably know best what will go thru and what wont. You could always pick thier brain about it. Also remember that you can always appeal.

[Jessica9190 127]

My problem is just last year I weighed 180 so my BMI was 30. In 2009 my BMI was over 40 but I don't remember if I went to doctor when it was. I lost like 70 pounds between February - August of 2009. I've bounced between 172(BMI of 29) and 220 (BMI of 37) several times over the last two years until this past February and I've been going up ever since now at BMI of 43. I don't know when I've been to the doctor between those times and what I weighed when I went. I guess I'm just freaking out and I should just chill until I can see the records. I can't help it tho. I have come so far. I would hate not to be able to be approved now.

[crazee 1]

I too have BCBS Federal. I had to get a 2 year history from my doctor showing that I had problem with weight control. I have type 2 diabetes. Once all paperwork was submitted, I had approval in just a few days. Good luck to you!!!

[tuturunner 29]

I have the same insurance and in a similar situation. I have a 40 bmi this year but the last four years I've seriously tried to lose weight so I bounced from 200 to 260. The times I went to the doctor I was usually lighter. I will be pulling records from Urgent Care as well since they recorded my weight as well. I'm just hoping that they see that I'm at least trying...but I can't seem to get below 200. I don't have any other health issues so if they are going to deny me...this is going to be the sticking point for me. I'm finishing up my last NUT this Friday so I should be sending in my paperwork soon. I'll let you know how it goes!

[Jessica9190 127]

Thanks tutu can't wait to hear from you to see how it goes. GOOD LUCK!!!

[mike010906 14]

I also had to do the 3 month supervised diet. I just cleared my pulmonology exam last week and waiting (not very patiently) for my date. It should be the beginning of December..

Hi there. I know this is kind of sidetracking the convo and I'm sorry but can u tell me what the pulmonologist exam consisted of? And do they fax over the clearance that same day? I have my cardiologist appt for clearance tmrw and w/ pulmonologist on Mon.

Thanks, appreciate it!!!!!

[notmeanymore 629]

I had to breath into this tube a total of 3 sets. First one was so they could measure the level of oxygen vs. carbon dioxide in my actual breath. The second time was for strength and the third to see how long I could hold my breath. It was really easy. I just sat on a stool and blew into the tube.

My particular pulmonologist faxed over that day because the results are immediate. I dont if they all send over the clearance that day but Im sure at least the next day if you tell them that you are really wanting to get cleared so you can get your date.

Once my surgeons office got the clearance, I got a call the next day.

Good luck!

[mike010906 14]

I had to breath into this tube a total of 3 sets. First one was so they could measure the level of oxygen vs. carbon dioxide in my actual breath. The second time was for strength and the third to see how long I could hold my breath. It was really easy. I just sat on a stool and blew into the tube.

My particular pulmonologist faxed over that day because the results are immediate. I dont if they all send over the clearance that day but Im sure at least the next day if you tell them that you are really wanting to get cleared so you can get your date.

Once my surgeons office got the clearance' date=' I got a call the next day.

Good luck![/quote']

Thank you so much!

[Raven21 121]

I have Aetna but just had the same problem. I went to the doc once in 2011, but never in 2010. I was able to get hold of an ER report from when I broke my leg in 2010 and fortunately it had my weight on it.

[Jessica9190 127]

Ok I got my records.

2009-238 lbs BMI 39.6

2010-241 lbs BMI 40.1

2011-216 lbs BMI 35.9

2012-257 lbs BMI 42.8

I was just recently diagnosed with hypertension because my blood pressure is somewhat high. I'm so worried and nervous I won't be approved. I mean all my weights show a BMI of over 35 but I didn't until now have any comorbidities. Anyone have any words of wisdom for me here?

[Jessica9190 127]

Come on somebody tell me what you think do you think that the Blue Cross Blue Shield federal will approve me?

[tuturunner 29]

Our weights have been in the same range! My final weigh in was today so they should be submitting my paperwork to insurance next week. I think others with our same insurance have gotten quick responses. Stay tuned and I will let you know. I have no other medical issues so we shall see. Stay positive!