XForeverYoursX 6 Posted July 26, 2014 what does your doctor consider a co-morbidity? Is it 1 or 2 that you need if you're under 40 bmi? is pre-diabetes one? thanks guys Share this post Link to post Share on other sites
joatsaint 2,814 Posted July 26, 2014 I think it really depends on your insurance requirements if it's one or two. I only needed one, I had sleep apnea. 1 alwaysvegas reacted to this Share this post Link to post Share on other sites
leelee2728 18 Posted July 26, 2014 I have BCBS and all they needed was a 5 year weight history and 1 co morbidity. For me it was my back and neck. I was in a car accident earlier this year and because it messed me up so bad I was able to claim that as my Co Morbidity. But, I do know pre-diabetes and hypertension are, on my insurance at least, considered. But that's Blue Cross Blue Shield. I am a 39BMI, funny how it's just not big enough to put ya through. :/ good luck! My date for surgery is August 7th... I wish you all the luck and speedyness that I had. (Started my journey 5/28/14 got my date for 8-7-14) Share this post Link to post Share on other sites
XForeverYoursX 6 Posted July 26, 2014 it's so silly that you have to be 40 but over 35 is severely obese. I'm in that situation where i'm about 7-10lbs too "small" to hit 40 but i'm pre-diabetic and i shouldn't be gaining anymore weight either. it sucks!! Share this post Link to post Share on other sites
leelee2728 18 Posted July 26, 2014 I know what you mean! It's ridiculous what they consider a qualification. The difference of 7-10lbs when it comes to a BMI, I just don't understand the insurance companies. I got soooooo lucky with BCBS... They just dropped the 6month weight loss trial. I would have been screwed and had to put it off till next Sept. Share this post Link to post Share on other sites
evann_rn 1 Posted July 27, 2014 Hi! I am in San Antonio. I am just started the process to get sleeved. I went to my pcp and was told I do not meet the criteria because my BMI in only 36.6. ONLY!! Are you kidding me?!? I have been battling my weight since I was 17. I have tried everything including prescription weight loss medications. Does anyone out there know other comorbidities that are covered. I am have a sleep study done to check for sleep apnea. I already have Migraines, reflux, and high cholesterol. I am feeling frustrated I didn't get a referral!! Share this post Link to post Share on other sites
sjohnston222 2 Posted July 27, 2014 Hi! I am in San Antonio. I am just started the process to get sleeved. I went to my pcp and was told I do not meet the criteria because my BMI in only 36.6. ONLY!! Are you kidding me?!? I have been battling my weight since I was 17. I have tried everything including prescription weight loss medications. Does anyone out there know other comorbidities that are covered. I am have a sleep study done to check for sleep apnea. I already have Migraines, reflux, and high cholesterol. I am feeling frustrated I didn't get a referral!! I had the sleeve done in San Antonio with Dr. Patel. He sent me for an upper GI and found I had a hernia. If you have reflux bad, you prob have one too. Do you have to have a referral from your PCP? Wear a weight belt under a big shirt ... That will increase your BMI. I had a friend do that! BTW Victory Med Cntr was the best! Share this post Link to post Share on other sites
evann_rn 1 Posted July 27, 2014 My husband is military and I have to have the sleeve done at SAMMC. I've read about wearing weight belts and ankle weights, but they just weighed me and it's in my record. I think increasing 10-15 lbs that quick might look suspicious?? Share this post Link to post Share on other sites
cdadams 7 Posted July 27, 2014 I have some of the same questions I have a BMI that low also but I have 2 co morbidities and my PCP said that bariatric surgery would be great for me. I am pre diabetic and high cholesterol. Oh and I have cardiovascular disease. I also have BCBS it does say that you dont need preauthorization for the surgery just to meet the criteria for it. I am very wary and nervous about it. I have my first doc appointment on Mon the 28 july. Share this post Link to post Share on other sites
mi75 1,235 Posted July 27, 2014 hypertension, high cholesterol. insulin resistance, sleep apnea, GERD, fatty liver, polycystic ovarian disease, Barrett's esophagus. these are what i had. others that can count are : fibromyalgia, cardiomyopathy, osteoporosis, joint disease needing replacement (due to weight strain), back problems, diabetes, pre-diabetes. it is really all about what your insurance requires. your surgeon or family doctor will be a big advocate in getting you approved, based on the letter that they write to your insurance about WHY you qualify. 1 BeagleLover reacted to this Share this post Link to post Share on other sites
MamaGav 3 Posted July 31, 2014 Lele@@leelee2728 I also have Blue Cross. Did you have to do a 6 month journal. I haven't met with the surgeon yet as I have to attend a seminar first. However I spoke on the phone with them. I more than qualify. I was just wondering what my wait will be! Share this post Link to post Share on other sites
BeagleLover 1,020 Posted August 11, 2014 Hi! I am in San Antonio. I am just started the process to get sleeved. I went to my pcp and was told I do not meet the criteria because my BMI in only 36.6. ONLY!! Are you kidding me?!? I have been battling my weight since I was 17. I have tried everything including prescription weight loss medications. Does anyone out there know other comorbidities that are covered. I am have a sleep study done to check for sleep apnea. I already have Migraines, reflux, and high cholesterol. I am feeling frustrated I didn't get a referral!! First, you need to check IF your insurance covers bariatric surgery. If covered, usually two co-morbidities, which you have mentioned, high cholesterol and sleep apnea should be enough to qualify. Also, you are over a BMI of 35. You need to change your PCP to one that is supportive! Share this post Link to post Share on other sites