I have Meritain. Panicking that I won't get approved?!

[rnsamantha 352]

I have Meritain insurance in AZ and am in month 5 of a 6 month supervised diet. My BMI was just over 40 (41.1) at the beginning of my weight loss, but now I'm at 39. I'm freaking out that if my BMI isn't about 40 they won't approve me. Although my surgeon doesn't require a sleep study, I requested one through my PCP due to my chronic snoring, because if I have sleep apnea my BMI only has to be 35 or above. My weight has fluctuated throughout the 6 months of supervised weight loss and last month I was up 5 lbs from the month before due to stopping phentermine, but still down 6 overall. To be honest I haven't been rigorous with my weight loss and exercise efforts because the surgeon even advised me not to lose too much weight due to my insurance requirements (BMI 40+ without comorbidities, 35 with DM, HTN, sleep apnea, or severe muscoloskletal disease) Anyone else have this experience??? I don't want to have gone through all the steps only to get denied at the end, and my husband will never be on board with me going to Mexico...

[Elode 8,093]

Waiting is the worst part! Even if someone else got approved with the same circumstances that does me you will or won't. It's hard not to let it drive you nuts but really all you can do at this point is wait and see. Good luck!

[scoutmom 63]

@@rnsamantha

Hang in there! I'm in a similar situation and I know it is so difficult to wait and go through this process. The end will make it all worth it!

S

[samanthafromAZ 2]

Thanks for the support. It feels a bit ridiculous to hope I have sleep apnea, but that's where I'm at presently. Insurance stinks. They happily collect a premium every month but make it difficult to use it. Okay...rant over ☺️

[Elode 8,093]

@@samanthafromAZ I agree but if they come through you will love them

[rp2907 36]

I am exactly where you are. I go in for my 6 month on 4/8/2015. I pray I get approved. My BMI is 45 I have asthma and I'm diabetic. I never thought it would be so stressful.

[jane13 2,256]

I am waiting as well I have high BP so I am "in" for just that but I am pretty sure I have sleep apnea (I snore) but the weight thing worries me too. I was told I could lose to 240 and still have a high enough BMI to make requirements but that the BP was the ace in my sleeve. I am just waiting........

[rnsamantha 352]

I'm sitting at 270 now. BMI of 39.9 and trying to maintain weight of 270-271 until my last weight loss visit with PCP this month. 271 puts me at 40.0. Sadly, still hoping for sleep apnea on my sleep study scheduled for April 15. Had my psych evaluation last week and results are pending. Feeling very anxious as this is the month where all the pieces need to fall into place. Hoping for a quick approval because I can't wait to change my life!

[cazam 7]

I am on my second level appeal with Aetna. they continue to deny based on missing information. Guess what, if they really looked everything's there. how frustrating!

[rp2907 36]

I got approved! !!! I Will get my surgery date soon.

[rnsamantha 352]

Congratulations! I'm still waiting, but was told today that they have determined I have met all the insurance requirements. Final review is still pending though. I'm hoping it won't be much longer!

[rp2907 36]

Where r u having your surgery at rnsamantha

[majorsmama 91]

How tall are you? You must be pretty tall to have a bmi under 40 at 270lbs!

[rnsamantha 352]

I'm 5'10. Well, technically 5'9 and 1/2! I've rounded down to 5'9 for all my PCP appointments so that what my BMI is based on.

[rnsamantha 352]

I'M APPROVED!!!! So excited!!!