3 year weight history question

[kondasa 28]

I was required to provide three years worth of weight history for approval from my insurance. I said to the surgeon when I met with him that my biggest concern is that I will be rejected because I have been such a yo yo dieter and depending on the time I weighed in at the doctors my weight could be over 40 BMI or under 40 BMI. I just received my history from my doctors and three years ago I was at a BMI of 37 and two years ago at 39-- under the required 40 BMI that I am at now. I have no co-morbidities.

Just a question- have any of you had this be your situation and how did it work with insurance? The surgeon said that he may need to fight with the insurance company, but that what he is looking for in a surgery candidate is someone who has been overweight for an extended period of time and not someone who just happened to gain weight after having a baby etc. Unfortunately, I don't know if insurance will care.

Thoughts?

[Inner Surfer Girl 12,015]

They may also consider comorbidities like high blood pressure, sleep apnea, etc. I wouldn't worry about it until your surgeon gets feedback from the insurance company.

[kondasa 28]

I don' t have high blood pressure or sleep apnea. I know it is a matter of time with my weight, but right now I look like a normal "healthy" person-- except for being 150 lbs. overweight.

[BLERDgirl 6,417]

That fact that you have progressively gained may work in your favor.

[Champ715 207]

My experience has been that insurance companies strictly enforce the rules because they want to find any and every excuse not to pay for your surgery. They will probably deny you if your BMI was below 40 at any point in the last 3 years. However, your doctor can submit an appeal and fight them. They may come back and approve you then.

All insurance companies and policies are different so your best bet is to call your provider and ask them directly.