Lower BMI - Insurance Question

loseit7 · December 7, 2007

I have a BMI of 35 and was told by my insurance (UHC) that the surgery would be covered as long as I have "other conditions". I have pre-diabetes and insulin resistance, but I have never been treated for either. My OB/GYN did a full blood workup a few years ago, then when the sugars came back high she had me do a glucose tolerance test. Both tests showed my sugars about 9 points away from diabetes and my insulin levels were super high. All I got from her was a little note that said "It's NOT diabetes". It wasn't until I looked up the numbers myself that I found out they were all out of whack.

My question is has anyone else here ever had a similar situation and had insurance approve right off if they can prove the sugar/insulin levels are in the abnormal/dangerous range, or did you have to undergo a period of treatment by an endocrinologist for a period of time before approval?

In addition to the sugar/insulin thing, I also snore like a freight train, get heartburn about three times a week (so bad that I throw up sometimes) and have high blood pressure. I guess I'm just borderline on the blood pressure thing - every time I go to the doctor they end up taking my blood pressure four or five times to make sure of the level. The last time I went to my PCP she gave me a diet to follow in an attempt to bring it down.

My first appointment with a surgeon is next week so I guess I should just be patient and wait till then, but I'm just so anxious/excited now that I've decided this is definitely what I want to do! Okay, sorry for the long post. Any advice/information/guidance you could give would be greatly appreciated!

kjl315 · December 7, 2007

You should ask the surgeon about having a sleep study done. You said you snore like a freight train, which is a good indication that you may have sleep apnea which is a comorbidity accepted by most insurance companies.

Good luck.