Those who have dealt with a denial- what was the reason for the denial?

[Nesa 51]

Is your BMI 40 or over?

Mine is at 48 my insurance waives all the extra stuff if BMI is at 50 =(

[skikyd 165]

I was denied because I do not live by a center of excellence and I would like to have surgery locally. I am still appealing.

I ha my surgery in a center of excellence. The day after surgery I had a cardiac complication.

I was damn glad I was in one if the best hospitals in the world. In about 2 minutes I was on a cardiac wing with the best doctors there are,

If a center of excellence is available---- go there. Your life is too precious.

[Skalleywag 12]

mine was I did not have co-morbids...but I do I have dyslipidemia and sleep apnea. Waiting for Surgeon office to do a peer to peer review. Still scheduled for surgery as of now but we will see....

[Nesa 51]

mine was I did not have co-morbids...but I do I have dyslipidemia and sleep apnea. Waiting for Surgeon office to do a peer to peer review. Still scheduled for surgery as of now but we will see....

My scheduled for sleep apnea test. If I have it I will be sleeved. Crazy insurance !!

[KittyChick 140]

For the folks who needed co-morbities for approval - who was your ins co?

[cindymg 629]

For the folks who needed co-morbities for approval - who was your ins co?

United Health Care. 36 BMI, 3 co-morbidities, 40 years of yo-yo dieting, pills, programs, etc. Approved in a week after submitting paperwork (it does pay to go to a Center of Excellence -- they know how to play the insurance game). Sleeved May 15, down 56 lbs. Best decision I ever made!

Hang in there! It will happen!

[skikyd 165]

I'm not sure if I needed co-morbidities but I had

High blood pressure

Cholesterol

And

sleep apnea

[skikyd 165]

For the folks who needed co-morbities for approval - who was your ins co?

I was

With Tufts Health care

[nh20013 15]

Good thread to start! Had I known about having a sleep study my approval would have gone right through the first time but I didn't think to go have one turns out I had sleep apnea and I did not snore! So don't think you don't have it just because u don't snore. Eventually it all worked out because I got approved just moved out my date a month... So if your submitting your paperwork and don't have any comorbids get a sleep study done you will be surprised I didn't think I had sleep apnea.

[Superfluous 19]

Thanks for all these replies. Now that I am waiting for approval, I'm finding these posts interesting and a little scary!

[Rena's got this 274]

I was denied by BCBS of Alabama because my BMI wasn't 40+ for the past 3 years, and my co-morbidities weren't on their list, or weren't bad enough. Also, my doc didn't sign the dietitian's notes on the 6 month diet that I did. That part has been rectified, and I am in the process of appealing the denial. I'm not getting my hopes up, but maybe I'll get approved somehow. My surgeon might have to get them to do a peer to peer review first.

[FitnFabfor2014 358]

Good luck! Hopefully you get good news.