Federal BCBS FEP Basic coverage, straddling the BMI line.

[TX302 3]

Howdy, I was hoping someone might have some insight to my situation. I attended my first seminar today and hope to schedule my 1st appointment soon, unfortunately that leaves me with more questions than answers at this time.

Anyhow - My BMI straddles 39.9-40.2 depending on the day it seems. I've been at 38+ for the last few years, marriage and a child seems to have helped it inch up a little. My concern is whether or not I can get approved without the typical comorbidities if I tally up at 39.9. The only thing I really have to work with is an old knee injury which makes walking an aching, painful experience and stairs are even more fun! I had a surgical repair performed which helped the problem, but it still hurts like tax season. I don't know if that would provide leverage for BCBS though, I can vouch that it has been a complete roadblock in getting in exercise and taking the weight off of it would help tremendously amongst other health benefits. Any thoughts?

[jane13 2,256]

Re-check your height (an inch can put you in a higher BMI) and have you got documented efforts at weight loss attempts? I had been seeing a endocrinologist, did WW, saw a crackpot doctor and attempted nutri-system over the last 8 years. My nut said I was now just under 5'8" and therefore my BMI was a little higher. My BP and possible pre-diabetic state put me in the "good to go category".

[TX302 3]

Height is accurate, though if I skip my boots and go with sneakers it might help I don't have any medically supervised/documented weight loss attempts in recent years, I did about 10 years ago but it suffered the same fate my latest personal attempts have, death by knee pain and rebounding. I have done several on my own in recent times with marginal results, I have that data on hand. I do have a family history of diabetes but I'm not in that neighborhood at the moment.

[jss1988 54]

I would honestly wear the heaviest clothes I could find to my consultations if I were you. I also have BCBS and it sucks that they are requiring me to complete 6 months of nutrition counseling before qualifying me for the surgery. I only say this because I was told by my counselor that if my weight drops below 40 BMI, that I will be disqualified. They are actually telling me to stay morbidly obese for 6 months but to follow the nutritional guidelines at the same time. Sounds kind of sick, right?

[TX302 3]

That was kind of what I was afraid of It wouldn't be a problem to put weight on but that's kind of NOT the idea lol. It sucks how insurance companies force you to jump hurdles to retrieve any of the money you've punctually supplied them with over the years.

[jss1988 54]

It's all a game... but eventually we will get what we want in the end... best of luck!

[SleeveandRNYchica 1,155]

FEP BLUE is 3 months of nut visits. Do you have your two year weight records documented? It can be from any of your drs. Also a great letter of necessity will help. Do you have GERD? I didn't have to have proof of WW I just told them what programs I has done. I have FEP BLUE BASIC and was approved for the sleeve quick. Now revising to bypass.

[Sharon1964 2,530]

Take your height without your shoes on. And yanno, we shrink as we get older.

[SarahLovy 6]

Have your height taken barefoot and chug a bottle or two of Water right before you weigh if a pound or two will make a difference.

[TX302 3]

Turns out I've not measured myself shoeless in quite some time, the numbers are much better regardless of my scale's daily opinion. Thanks for the suggestion

[purplegirl20073 33]

I have FEP BASIC also. They require the 3 months of weigh ins. I am currently at 40 bmi and I was told to maintain my weight until my last weigh on 8/3, then start pre-op diet for surgery schedule 8/14. It is killing me that I have to eat so much food to maintain when all I want to do is start my better eating habits. I agree with the "wear heavy clothes" comment. My first weigh I was under 40 and they can't include that weigh for the insurance approval, that's why I need my Aug weigh.