Concerned about insurance approval with TriCare Prime

[Amber W. 37 0]

So I'm just starting the process of trying to get approved and I'm concerned I may get denied. My current BMI is 38 and per my insurance requirements a BMI under 40 requires one comorbidity. I do have degenerative disks and other issues in my back and had Gestational Diabetes while pregnant but as far as I know I'm not currently diabetic. I don't know about high cholesterol or sleep apnea but I know my blood pressure is fine. For those that have been through the process and have has similar circumstances what was the outcome? Does the doctor give a full medical workup while you are going through the process to quick for some of these other conditions? It's definitely possible I have co-morbid conditions I am unaware of.

[crystalschnarr 7]

There are other comorbidities that they will consider but without testing for it you won't know if you have it. Back in 2010 when my husband was deployed I started having heartburn really bad. Was put on Nexium. Went through a weight loss program with my doctor to try diet, exercise, and an appetite suppressant. It helped but after my husband came back I put it all back on because he didn't understand why I was buying food that no one else would eat. Was approved to start the process for the LapBand and that is when they did my first upper endoscopy. Because of my reflux this was required prior to surgery. They found that I had a Hiatal hernia (where part of your stomach slips up into your chest) and Esophageal issues. Long story short I couldn't get the lap band due to my reflux but now that I have treated my esophagus I am going back to address the weight. My Hiatal hernia is considered a comorbidity. Talk to your doctor. They may want to run some other tests to ensure there aren't any other underlying issues. A lot of people have reported not knowing they had a hernia until after the doctor did their sleeve or RNY. Keep communications open between you, Tricare and your doctor so you will be able to consider all possibilities.

[Amber W. 37 0]

Thank you that is very helpful advice. I've made an appointment to have a full physical with my doctor and I will discuss further testing.