Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

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

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

Frenchie what insurance do you have?

Sent from my iPhone using the BariatricPal App

Edited by MemphisWLS

Share this post


Link to post
Share on other sites

AARP Medicare complete

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

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

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

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

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      I FINALLY HAVE MY DATE!!!!

      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×