BCBS of Ala- 100pds or BMI of over 35????

gagegrace · February 18, 2008

My BMI is somewhere around 37 or 38. I'm 5'10 and weigh about 246. I have treated high blood pressure. I've just about given up on the hope of having this surgery because I don't have a 3 year history of a BMI over 35. Very close though, like 220 one year, 232 another. BCBS of ALA requires a 3 year history of weight and height showing a BMI of 35 or more with pre-existing illness. Here's the question: Eventhough my BMI history is not above 35(except for now), currently I'm technically right at 100 pounds over weight if you go by height and weight charts. Does anyone know if I have a better chance now with that being the case or do I need to show a 3 year history of that weight? Actually a weight of 152 is the lowest for my height and frame. I could easily gain those few pounds to be exactly 100 pounds over. Hopefully someone with this type of insurance might enlighten me, but any experience with this I'd appreciate.

Kat817 · February 18, 2008

Much of this will depend on your Dr.'s office, and how willing they are to work with you during the preparation of the packet to send to insurance. If you weighed more during a visit in May of one year than you did in November of that year, or were having weight related issues, that is the part that needs included. It is a simple building of ones case. You can get records from your gynecologist, if anywhere in there, it refers to weight issues, they can help. ANYTHING!!! If you ever saw an orthopedic Dr. for joint pain that they considered your weight an issue with---it too can be included.

If during any of the time, you were attempting to lose weight, and can show receipts to say Weight Watchers, or Jenny Craig---those can be included.

Blood work can be included to show raised levels of triglycerides, or high cholesterol #'s.

A print out from your pharmacy showing how long and what all medications you have been on for Hypertension can be included.

I have heard of people who send pictures---and letters of how the weight compromises their lives. As well as those who have sent a comprehensive family history. If your parents have health issues, or a grandparent or sibling died young or had a heart attack before the age of 40---anything of that nature.

Another issue that has been raised recently, that might help that is to have yourself re measured height wise. Many have found themselves an inch shorter than originally believed---which altered the BMI.

Gather as many of your records from as many Dr.'s as you can----go through them, find the ones that best represent your case. Do not lie in any way----let your own history tell the story.

If you are willing to gather the info from other Dr.'s and have the additional paperwork for your PCP's office staff, they are often times more willing then to work harder with you, they feel you are working with them.

Good Luck---don't give up!

Kat