Just starting out

[Fingerscrossed2112 4]

Hello, I’m just starting the process I have an appointment next week to start stage one of Molina Washington state requirements. I’m nervous because my BMI is over 40 which is on the list for being approved but I don’t have any comorbidities. Does any have any experience being approved with just a bmi over 40?

[GreenTealael 25,335]

What does the insurance wording say?

“BMI of 40 or X with comorbidities

Likely it is an either/or situation not necessarily both but if it’s not written clearly, contact them for the clarification.

[Fingerscrossed2112 4]

6 minutes ago, GreenTealael said:

What does the insurance wording say?

“BMI of 40 or X with comorbidities

Likely it is an either/or situation not necessarily both but if it’s not written clearly, contact them for the clarification.

Must meet one of the following three criteria:
1. Must have a minimum body mass index (BMI) of > 30 with a diagnosis of Diabetes Mellitus.
2. Must have a BMI of > 35-39 and must have at least one of the following conditions:
a. Degenerative joint disease of major weight bearing joint(s). The member must be
a candidate for joint replacement surgery if weight loss is achieved.
b. Other rare chronic conditions (for example, pseudo tumor cerebri) in which there
is medical evidence that bariatric surgery is medically necessary and that the
benefits of bariatric surgery outweigh the risk of surgical mortality.
3. Must have a minimum BMI of > 40
Here is their wording. I’m obviously number 3 I’m just worried it’s a case by case basis and they won’t approve me.

[AmberFL 746]

mine says the same, I was 43BMI but no comorbidities. I was approved.

[GreenTealael 25,335]

You should be fine!

[NickelChip 1,211]

It won't be case by case. If you are 40 BMI, you will qualify without co-morbidities. Their wording is clear enough you could take it to court if they denied you.

[Bypass2Freedom 711]

Sounds like you'll definitely be approved by the looks of their wording!