Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Am i wasting my time?



Recommended Posts

Hi everyone. I have BC/BS of Maryland. I'm not sure if I'm wasting my time or setting myself up for disappointment. I was wondering if anyone here has a similar story to mine and if so, how did it turn out? Ok so the criteria for my ins is pretty basic. 1. 40+ Bmi ; 2. 35-40 bmi with one comorbid (their comorbids are sleep apnea, diabetes, hypertension or "any other serious illness or medical condition related to weight") ; 3. Psych Eval. ; 4. 6 moths supervised weight loss.

That's it. My only issue is my BMI according to BC/BS is 38.9. None of the comorbids. I'm getting tested for sleep apnea soon. Hopefully it will come back that I have sleep apnea. If not someone suggested I gain the extra 8-10 lbs needed to hit a 40 BMI. I start the weight watchers meetings next week. I guess I will contact a bariatric surgeon after I get my sleep apnea results? Or should I contact them

Now?

Share this post


Link to post
Share on other sites

I would contact them now and let them know where you are at. I actually gained 6 lbs on purpose to meet the requirements, plus I had high cholesterol which counted as a comorbidity. I thought it was a "long shot" that my insurance would accept me. But they accepted me, and I am so glad they did. It was worth the trouble.

Share this post


Link to post
Share on other sites

Do you have any documented back/hip/knee issues? BCBS-IL counted my lower back issue as a comorbidity. Good luck and either way, I don't think you're wasting your time. It's well worth the fight.

Share this post


Link to post
Share on other sites

Thanks for the reply! Ok I wasn't sure if I should wait or do it now because I've heard of insurance companies going by the weight of your first surgeon appt. I also have high cholesterol, maybe that falls under their generic comorbid -'any other medical condition due to weight'. They don't really elaborate on that.

Share this post


Link to post
Share on other sites

No but I do have documented neck problems, degenerative disc disease that my chiropractor says is from weight

Share this post


Link to post
Share on other sites

To gain a few pounds now to help you for the rest of your life may be worth it. I also had BCBS and I had no problems getting approved, just had to do all my pre-op stuff, I was just at 40 BMI.

Share this post


Link to post
Share on other sites

If its a matter of gaining less than 10 pounds to qualify - I say go for it!

Share this post


Link to post
Share on other sites

Wear combat boots when you get weighed for the insurance! Seriously, the high cholesterol and neck and back problems should qualify. No matter what your starting weight, they will want you to lose a few pounds to decrease the size of your liver before surgery any way. So if you were close to the BMI weight, you might be a little under after dieting for surgery any way.

Share this post


Link to post
Share on other sites

I have same BC/BS Maryland too (CareFirst MD). My BMI hovers between 36-37 and I have hypertension & high cholesterol.

I'm in 6 month program at GBMC. Are you working with a program now? The one at GBMC has guided me through the process step by step. They provided a ton of info, nutritionist, etc. Had psych eval, etc.

My 6th visit is on 6/4/13 when they schedule surgery and submit for insurance approval. I'll be holding my breath until I hear if it is approved since the policy was just revised on 3/25/13. .

I don't think you are wasting your time, especially if the sleep study comes back positive for apnea.

Share this post


Link to post
Share on other sites

I have Anthem BCBS. I started my processing on March 16 starting with the seminar. 4 days later I met with the surgeon. I needed to gain 13 pounds because my bmi was 38 with no commodities. Finally on April 30th I was at my 40 bmi. Had my psych appointment on May 16 she told me that she was clearing me. Just waiting on insurance approval.

Share this post


Link to post
Share on other sites

I added on 10 pounds weights when I seen the surgeon & my physical under my breast. U have to loose weight before surgery anyways. I wa approved Mat 18th

Share this post


Link to post
Share on other sites

My surgery days is July 8

Share this post


Link to post
Share on other sites

I had a bmi of 36.1 and it turned out I had severe sleep apnea. I had no idea!!! Are you tired in the morning? No energy? Do you snore? Has anyone told you that you are very restless in your sleep?

Share this post


Link to post
Share on other sites

Hi everyone. I have BC/BS of Maryland. I'm not sure if I'm wasting my time or setting myself up for disappointment. I was wondering if anyone here has a similar story to mine and if so' date=' how did it turn out? Ok so the criteria for my ins is pretty basic. 1. 40+ Bmi ; 2. 35-40 bmi with one comorbid (their comorbids are sleep apnea, diabetes, hypertension or "any other serious illness or medical condition related to weight") ; 3. Psych Eval. ; 4. 6 moths supervised weight loss.

That's it. My only issue is my BMI according to BC/BS is 38.9. None of the comorbids. I'm getting tested for sleep apnea soon. Hopefully it will come back that I have sleep apnea. If not someone suggested I gain the extra 8-10 lbs needed to hit a 40 BMI. I start the weight watchers meetings next week. I guess I will contact a bariatric surgeon after I get my sleep apnea results? Or should I contact them

Now?[/quote']

Perhaps you are a inch shorter ?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×