I need a co-morbidity or no approval

[kittydream 2]

I'm about a month and a half into the process, I have BCBS Premera and apparently they're very particular about the insurance requirements. I am 5'10, 253 and am required to have a co-morbidity. The only one I come close to is sleep apnea. My pcp ordered a sleep test for me. If I dont have moderate to severe OBA I will not qualify. If I gained 30 lbs I would not need a co-morbidity. Ugh. Has anyone had to do a sleep study?

[ambpete 26]

Het Kittydream,

I just completed my sleep study few weeks ago. And I found out that I do have sleep apnea. My breathing stopped 48 times in a hour so it is a concern. I have been cleared by all my other doctors at this point. Tomorrow I will meet with a home care company to be fitted for a mask to help my breathing. It will be monitored for a few weeks and if my apnea improves with its use, they will clear me for surgery. This is the last part of my testing so I am ready to get on with getting an approval. I am expecting to have it done in June if all goes well. I will keep you informed of my progress. I started this journey in December so its moving right along. Good luck with all you are going thru and I think you will get a lot of help from all the folks on this site

[kittydream 2]

@ ambpete - thx for the info! I have been scouring the threads- so much helpful information and support. Gosh, so not only do we have to be diagnosed with sleep apnea but we also have to be monitored with a cpap and show progress?? Is that what you are finding common with the insurance requirements?

[ambpete 26]

In my case I need to show progress in the early stages of using my cpap because my doctor requires it. I will be out of the country for 2 weeks in early May, so I want to get isurance co. approval before I leave. As long as I show improvement for the 3 weeks before I go back to the doctors, they will clear me. I will have to use the cpap machine until I actually have the surgery. And as you know, one of the benefits of the weight loss should be the regression of the sleep apnea. So i'm confident that it will improve and I can get on with this. My insurance co. is actually run by doctors, so their approach to approval is quite different. I am not sure about other insurance, but that's how mine works.