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

Anyone was denied because...



Recommended Posts

Anyone was denied because they were not diabetic, had high blood pressure or etc. My date won't be until the end of the year, but still would like to know is possible to get denied because no issues expect for high bmi (46)

Share this post


Link to post
Share on other sites

It all depends on what your insurance company's rules are. You should have a booklet of benefits (member handbook) that lists the criteria for coverage of bariatric surgery. Most insurance companies will pay if your BMI is 40 or over even if you don't have any weight-related problems, but some have different rules.

Share this post


Link to post
Share on other sites

If you are under BMI of 40 or if your insurance requires you to have those. I have Oregon health plan and they require everyone to have diabetes.

Share this post


Link to post
Share on other sites

Anyone was denied because they were not diabetic' date=' had high blood pressure or etc. My date won't be until the end of the year, but still would like to know is possible to get denied because no issues expect for high bmi (46)[/quote']

My insurance says a BMI of over 40 is enough to qualify without anything else. I have Horizon BCBS.

Share this post


Link to post
Share on other sites

Check your insurance co website. Most will have their clinical policies out there for public view. It should list the criteria you must meet to get it covered. Some will cover if BMI 40 or more w/o medical conditions.

Good Luck

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

    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
    • 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!

  • 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

    ×