Frenchie1977 262 Posted August 6, 2016 I just found out that my insurance doesn't qualify me for surgery with a bmi over 40, they will only qualify me with bmi over 35 with a co morbidity. I don't know if I have any Comorbitities, I'm pre-diabetic not diabetic, I have Migraines and that's about it. My first appointment with the surgeon is the 10th and now I'm worried that I won't qualify. I'm freaking out, I really need this surgery. Share this post Link to post Share on other sites
Qwalla 132 Posted August 6, 2016 I know that sleep apnea, high blood pressure are a couple. Hopefully you will get the answers you want. Good luck with that. Hope things work out for you. Share this post Link to post Share on other sites
MemphisWLS 58 Posted August 6, 2016 (edited) Frenchie what insurance do you have? Sent from my iPhone using the BariatricPal App Edited August 6, 2016 by MemphisWLS Share this post Link to post Share on other sites
Frenchie1977 262 Posted August 6, 2016 AARP Medicare complete Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
MemphisWLS 58 Posted August 6, 2016 Did you talk with a rep at your insurance? Is it insurance specific or plan/employer exemption? I am looking at the general info on the aarp Medicare plans and they do have the generic lingo, " you may be a candidate if you have a bmi over 40 and have tried other weight loss methods without success.....etc. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
Frenchie1977 262 Posted August 6, 2016 I talked with an insurance rep when I was asking questions about the qualifications filling out a list of questions the surgeons office gave me Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
MemphisWLS 58 Posted August 6, 2016 Oh my. I just went to cms.gov to do some research, the rep is right. You hv to have bmi 35 with sleep apnea, hbp, DM etc directly related to obesity. I am sure there might be a way to appeal this, maybe a very strong letter form your doctor? Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
