bcbs BCBS Federal Co-Morbidity Requirements

[Lulu5 24]

Hi! I'm new to this entire process. I've been doing lots of research on the VSG and I feel it is my best long-term, weight loss option. I have BCBS Federal and I am required to have at least one co-morbidity since my BMI is less than 40, but greater than 35. My BMI is currently 35.5. I called BCBS to ask them what co-morbidities they count as significant for approval and they said:

high blood pressure

diabetes

sleep apnea

I don't have any of these things. But I do have:

Migraines

prehypertension

osteoarthritis in my spine and hips

scoliosis

knee/joint pain

BCBS did tell me that since I do not have any of the 'major' comorbids, that I higher level supervisor would have to review my case and make the decision.

My question is, did any of you get approved for your surgery through BCBS and you did not have high blood pressure/diabetes/sleep apnea? And if you did get approved, what were your comorbidities?

Thank you!!!

[JessicaAnn 564]

Did you have a sleep study? Because I didn't think I had sleep apnea. I had no symptoms, slept pretty well, but when tested I do have it.

[sleeve_sister 110]

My BMI was over 50 so I qualified without having to have any or do anything. However, we are going through this with my husband right now. They told us that since his BMI is over 35, he doesn't have to have a co-morbidity. We also have Fed BCBS. Have you consulting with a surgeon yet? They can usually get more accurate information than what they will give us over the phone. Also, I agree with prior post...ask your PCP for a sleep study to rule it out. That could be your IN without any problems getting approval. Good luck to you. This has been the best decision I've ever made for myself. 8 mths out and 113lbs down.

[Lulu5 24]

Thanks ladies. I have not had a sleep study, so maybe this is something I need to look into. Also, I am in the process of setting up my first appointment with my surgeon. I am in the very early stages of everything. Thanks for your input!

[Austin1966 7]

Hi Lulu5 I'm new to the process also. I just submitted my paperwork for preapproval to my insurance. My BMI is 36 and I have HBP and I was diagnosed with sleep apnea last Sept. I have BCBS Federal Texas and I'm really nervous because my last two years I fell below 36 BMI. I'm hoping to hear from the surgeons office next week.