12/14 sleeve surgery-pending surgical auth

[rgilio88 2]

I have been up and down with my weight for my whole life and before when the only options were bypass or lap band I wasn't ready for either, however this seems like the perfect option for me. So I've followed with a weight loss md and my surgeon for 6months, completed all the lab work, done my pulm and cardiac consults, passed the psych eval, visited multiple times with the dietician. All I'm waiting for is my surgical authorization which I've met all the listed requirements for. However, my insurance denied me stating I need a bmi of >50, even though the criteria the insurance company previously told me was >40. My bmi is 42. Now my surgeon is having a peer to peer consult with the insurance but I'm concerned I won't be able to proceed and I'm scheduled for 12/14..anyone else have any similar issue?

[karen091866 120]

So sorry that you're having to deal with insurance ordeals - Most insurances require a BMI of >40...or 1 or more comorbid conditions (diabetes, COPD, etc) ---A BMI of >50 is really restricitve criteria to a lot of people that could/ should be able to have the surgery of their choice to get their health back on track, but aren't in that BMI range.

hope things resolve quickly for you!

[beckyrow 18]

My surgery is 12/14 too. I hope they get yours worked out!

[Amy Wolfe 49]

12 14 here too!

[ChristianMM 0]

I'm a 12/14 too. I hope things get resolved quickly. My insurance is a bmi of 40+. Or if it was less than 40 must have at least one comorbidity. I don't understand how yours could have said 40+ and then suddenly 50+. Hopefully your surgeon can convince them or whatever he needs to do. Best of Luck!

[npmadsen 0]

I'm having mine 12/14

Hope you get approval my insurance is Bmi 40 or between 35 to 40 with a co morbidity

[Amy Wolfe 49]

Looking forward to following the journeys of my fellow 12 14 sleevers. Feel free to follow me on fb amywolfe1976@yahoo.com. i don't hide anything.

[DaisyAmy 561]

Dec 14 here, too! One week, folks!!!