LMJLMJ 0 Posted June 5, 2007 I have BCBS of CA Federal Basic. WLS is covered w/ a BMI of 40 or 35 w/ comorbidities. Ive had my surgeon visit and he thinks I definitely qualify. My BMI is 37.4. I have hyperlipidemia (high cholesteral AND high triglycerides, metabolic syndrome or prediabetes, depending on which Dr, they say different things. I also have infertility, stress incontinence, gerd, undocumented hip/feet/back pain and I just found out today that I have PCOS. Im hoping that PCOS diagnosis will help towards approval. What do you think? I will have my upper GI to check for hernia, psych and nutritional evals next week and then will be able to submit to insurance. What do you think my chances are? Share this post Link to post Share on other sites
chimboree26 24 Posted June 6, 2007 I have BCBS of CA Federal Basic. WLS is covered w/ a BMI of 40 or 35 w/ comorbidities. Ive had my surgeon visit and he thinks I definitely qualify. My BMI is 37.4. I have hyperlipidemia (high cholesteral AND high triglycerides, metabolic syndrome or prediabetes, depending on which Dr, they say different things. I also have infertility, stress incontinence, gerd, undocumented hip/feet/back pain and I just found out today that I have PCOS. Im hoping that PCOS diagnosis will help towards approval. What do you think? I will have my upper GI to check for hernia, psych and nutritional evals next week and then will be able to submit to insurance. What do you think my chances are? I know each insurance varies, but from what you've listed (BMI and co-morbidities), I certainly don't see why you wouldn't be approved. I have Carefirst/BCBS and I was approved about a week ago. I, too, have PCOS. My surgeon said that was very important in getting approval, soooo...just from my personal viewpoint, I would think you should be good to go. Again, all insurance vary, so I don't want to give you false hopes, but it seems that you have a pretty good chance of approval. Keep us posted!!! Share this post Link to post Share on other sites