Fingerscrossed2112 4 Posted June 11, 2024 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? 2 GreenTealael and Bypass2Freedom reacted to this Share this post Link to post Share on other sites
GreenTealael 25,430 Posted June 11, 2024 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. Share this post Link to post Share on other sites
Fingerscrossed2112 4 Posted June 11, 2024 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. 1 1 Fingerscrossed2112 and GreenTealael reacted to this Share this post Link to post Share on other sites
AmberFL 887 Posted June 11, 2024 mine says the same, I was 43BMI but no comorbidities. I was approved. 1 1 GreenTealael and Fingerscrossed2112 reacted to this Share this post Link to post Share on other sites
GreenTealael 25,430 Posted June 11, 2024 You should be fine! Share this post Link to post Share on other sites
NickelChip 1,313 Posted June 11, 2024 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. Share this post Link to post Share on other sites
Bypass2Freedom 852 Posted June 12, 2024 Sounds like you'll definitely be approved by the looks of their wording! Share this post Link to post Share on other sites