I so worried. I met with the insurance coordinator at my surgeon's office.

[kplant 0]

she didn't listen and was so confusing. I told her several times that I have hypertension and that my insurance may approve it based on my record of being at 38% BMI and she kept asking for records of being 40%. I don't have them. She also kept telling me that my ins said I need two comorbidities and she even called the ins and they said 'no, just one' and when she hung up, she kept asking me what the other comorbidity was. She also told me I need to show two years of records. I have stuff from 2005 (and earlier), 2007 and 2008. She said I will get rejected because I need 2006, 2007 and 2008. Finally, she told me to not take my meds for hypertension as "controlled" hypertension isn't a co-morbidity and it clearly says on the web site that it is. I am just absolutely freaked out she will screw this up. Should I trust her or have the surgeon "speak to her about my file".

[Kathy1991 0]

Talk to the surgeon. That's ridiculous.

Ks

[gina0922 0]

she didn't listen and was so confusing. I told her several times that I have hypertension and that my insurance may approve it based on my record of being at 38% BMI and she kept asking for records of being 40%. I don't have them. She also kept telling me that my ins said I need two comorbidities and she even called the ins and they said 'no, just one' and when she hung up, she kept asking me what the other comorbidity was. She also told me I need to show two years of records. I have stuff from 2005 (and earlier), 2007 and 2008. She said I will get rejected because I need 2006, 2007 and 2008. Finally, she told me to not take my meds for hypertension as "controlled" hypertension isn't a co-morbidity and it clearly says on the web site that it is. I am just absolutely freaked out she will screw this up. Should I trust her or have the surgeon "speak to her about my file".

Is she insane? :thumbup: Is she even hinting to you that you should stop taking your BP med? The reason for the surgery to to eliminate the need for the BP meds due to weight loss that comes from the surgery. That is like saying well you need to have a comorbidity like type 2 diabetes to be approved for surgery but if the med's your taking for the diabetes is controlling it, then you won't be approved because of the med's or insulin, you have normal blood sugar readings. What the hell is she talking about?? You really need to speak to the surgeon about that. She could cause someone some serious medical problems if they were to stop taking a needed prescription. :thumbup:

[MacMadame 81]

I think it depends. My insurance wouldn't accept my hypertension as a co-morbidity because it's easily controlled with very little of the first level medicine. If I went off my medicine, at most my blood pressure would climb to about 145/85. This isn't good, but I don't think it would *really* be life threatening if I did it for a month or two. In fact, at times my PCP has me go off them for other reason for a day or two.

But to make work for insurance purposed, I'd have to lie and say that I was taking the medicine and it wasn't working. That would be insurance fraud and *that* is definitely a bad idea, whether or not going off my blood pressure meds was a good idea.

[kplant 0]

sort of the point is that the meds are no longer controlling it. I am meeting with my GP for the 6 month diet requirement and we are working on finding something that works. He upped the diuretic to a very annoying level (I pee all the time) and it doesn't seem to be working. The next step is stronger (and more expensive) meds. I also had pretty severe edema in my foot that we are investigating (again, more money).

[MacMadame 81]

Sounds like you are okay if you are having real trouble with controlling your HP. That is definitely a co-morbidity for every insurance company I've looked at.