Fidelis/Medicaid

[torezz1111 3]

My last recorded bmi was 40.. I have back issues- lung issues and depression due to being overweight. I have been seeing my surgeon for 6 months.. anyone get denied with similar issues? I’m scared insurance won’t approve it.

[SpartanMaker 1,073]

The current clinical practice guidelines that pretty much all insurance companies use (assuming your insurance even covers bariatric surgery), consist of the following: BMI of 40 or higher, OR a BMI of 35 with at least one of the following comorbidities:

• Clinically significant cardio-pulmonary disease (e.g sleep apnea or OHS)
• Coronary artery disease or Cardiomyopathy
• Coronary hypertension (high blood pressure)
• Type 2 diabetes

Some also consider:

• hyperlipidemia
• NALFD or NASH
• GERD
• Asthma
• Venous stasis disease
• Severe urinary incontinence
• Debilitating arthritis

Your best bet will be to talk to your surgical team as they can help navigate your specific insurance.

[torezz1111 3]

My insurance covers it but doesn’t list asthma as I was told. I have asthma and restricted breathing and gerd and serve arthritis

[torezz1111 3]

I also have High cholesterol my cholesterol is 250 and ldl 180

[Lisaoptimist 0]

How did it work out?