BMI & Comorbidities

[MrsB2007 90]

My insurance (AHCCCS - Mercy Care) requires BMI of 35+ with 1 comorbidity. My BMI is over 36, but I am unsure if I have any comorbidities. My PCP just had me do a ton of blood work yesterday (liver, kidneys, diabeties checks, WBC check, etc etc etc).

This surgeons office has a list of comorbidities.. Which, according to that particular list I have about 3 or 4 of them (anxiety, depression, back pain, migranes, headaches etc). Has anyone been approved with issues other than the typical sleep apnea, diabeties, high blood pressure, etc??? (regardless of ins co)

I have read a lot about the NO weight gain thing. I have been seeing a nutritionist, eating right, exercising regularly, etc.. but my GYNO put me on the Depo shot for my endometriosis pain. The Depo has made me gain 10lbs (prior to my first weigh in).. If the weight gain continues can I tell the ins co the depo caused weight gain, not my poor eating habits?

I am confident I can manage my weight (and lose some here and there even) but with the depo theres no telling how much I will gain anyway. Anyone had this issue? What to do?

[LindafromFlorida 1,542]

I just want to say good luck. My husband and I had several co-morbidities. I hope you qualify, because it is a shame you have to wait for the co-morbidities to develop before you can get healthy.

[Susysleever 265]

Hello. I have mercy care too and 35 bmi. I dont have comorbids, then I see they have depression. I probably have sleep apnea. What is the no weight rule? They have me on meds that cause weight gain (abilify then seroquel now geodon) If you gain weight, you get rejected?

Edited August 15, 2014 by Susysleever

[lawchica 1]

I have AHCCCS Mercy Care as well. You can not gain ANY weight on the six month weight loss diet otherwise they will deny your claim. I gained 6.6 lbs during two months and then at the end I lost 14 lbs from my start weight to my end weight (20 lbs if you count that I also lost the 6.6 lbs I gained). I was denied for gaining weight during the plan. Don't let your weight ever creep up over the starting weight or you will have to start over. Right now I am going back to my highest weight during the 6 months and using that as my starting point so I will only have to do 3 visits more before we can resubmit it for surgery.