Sharhoward0816 0 Posted October 15, 2020 My doctor referred me to a bariatric surgeon. I am scared that my insurance won't cover it. I have a BMI of over 50 for my height. Share this post Link to post Share on other sites
The Greater Fool 2,054 Posted October 15, 2020 Welcome to the forums. My bet is that if your insurance covers WLS a 50 bmi is the beginning of the things you need to get surgery. Your surgeon's office will know what all the requirements are, so presumably when you talk to them they will give you a roadmap. If you want to get a jump on it, your insurance has a website that likely addresses it. If you can't find it, the Customer Service folks at your insurance can help. You also need to start researching the different surgery types, their plusses and minuses, and which will suit your situation and habits better. It's best if when you talk to your surgeon you are informed and defend your preference. You have to do a lot of your own work, and become your own advocate. Sitting back and waiting for it (not that you are doing this) will not get you WLS. Good luck, Tek Share this post Link to post Share on other sites
Sharhoward0816 0 Posted October 15, 2020 Thanks for the reply but what would I have to do? Because you said I would have to a lot of the work myself. My insurance doesn't have a specific area but it has surgeries. Doesnt say anything about cosmetic surgery though. Share this post Link to post Share on other sites
Sharhoward0816 0 Posted October 15, 2020 I also have knee and back problems due to weight. Share this post Link to post Share on other sites
The Greater Fool 2,054 Posted October 15, 2020 20 minutes ago, Sharhoward0816 said: Thanks for the reply but what would I have to do? Because you said I would have to a lot of the work myself. My insurance doesn't have a specific area but it has surgeries. Doesnt say anything about cosmetic surgery though. Knee and back issues would be comorbidities. WLS is *NOT* cosmetic, especially with a 50bmi and comorbidities. It is literally a life saving, health restoring surgery. Your insurance and surgeon are going to require all kinds of tests, history, likely documented weight loss efforts. You don't just sign up and get a date. You may have to take classes on the program. Every surgeon and insurance have different requirements that *YOU* must accomplish. They will tell you what and how. You need to RESEARCH (Interwebs work well) on the different surgery types. You need to understand each of them. This is important so you can advocate for the best choice for you. You will not succeed if you don't educate yourself. You found this site, you went through others. Now READ them to educate yourself. Again, your surgeon will help you with a road map. Your Customer Service at your insurance can help you also. *IF* you don't find what you think you need, keep trying. It's on you. Learn, learn, learn. I spent several days, all day, reading sites, journals, sites that explain the surgeries. Don't let them do something to you that YOU don't understand. It's all up to you. Good Luck, Tek Share this post Link to post Share on other sites
The Greater Fool 2,054 Posted October 15, 2020 I looked this up for you: https://www.azcompletehealth.com/content/dam/centene/policies/clinical-policies/CP.MP.37.pdf Tek 1 1 Sharhoward0816 and VickieRenee reacted to this Share this post Link to post Share on other sites
Sharhoward0816 0 Posted October 15, 2020 Yeah I had downloaded that too. But I didn't know if that was updated or not. Share this post Link to post Share on other sites
The Greater Fool 2,054 Posted October 15, 2020 If it's on their website, it's their current policy. 1 Sharhoward0816 reacted to this Share this post Link to post Share on other sites