Approved!!!! 48 hrs. BCBS, Low BMI

[Band_Groupie 3]

Doing the Bunny-Hop Here!!! Da-da da-da da da...DA DA DA! I'm an April Bunny for sure now...they're stuck with me!!! 'Cause I'm approved!!!

It took only about 48 hours! I have Highmark PPO Blue (BCBS of Western PA- Pittsburgh). My BMI was low, but I didn't go below the 35 BMI minimum for my 6 mo. diet (so I only lost 9 pounds). If anyone else has this insurance and needs help, just send me a PM and I'll be glad to share.

Off to hop around some more!!!

[BlessedTwice 1]

Congrats...I'm happy to hear you were approved! :scared2:

[sexylips 1]

whoooo hoooo .....you got a date congratts...lol

[rguay 0]

I also have Highmark BCBS. I am scheduled for May 27 at West Penn. Just named one of the top 100 hospitals in the US. Thank God since I am older and don't like the idea of any surgery.

I am just about finished jumping through the hoops, but I do have one worry.

I haven't lost any weight since I started 5 month ago.

My BMI is 40.1 with medication for hypertension.

I would say I am A-OK except for the lack of weight loss. I didn't want to go under 40.

What do you think?

[Band_Groupie 3]

I'd check your specific policy and I'd talk to the insurance person in your surgeon's office, but here's my advice.

I only needed one comorbidity (of the big ones, like hypertension) treated with medication to be approved with a BMI between 35-40 (I also only have hypertension treated with meds.). So if you fell below the 40, I think you'd still be fine. You absolutely do not need to lose anything (both AGH and Magee actually told me to keep it between 5-10 pounds and not to go below the 35 BMI), but if you gain even one pound they can deny you. If you have a pound or two wiggle room between where you are and the 40 BMI (just to be safe), then I'd try to lose those 2 pounds by the 6th month. I believe it's also OK to go up some months as long as you don't gain for the total. Let me know if there's anything else I can help with. Highmark's the best...I sure feel fortunate to have them!

Edited April 6, 2009 by Band_Groupie

[genetic_gem 1]

That's awesome! I have my last appointment with my doctor for the 6 months next Friday, and then they will send everything in to UPMC (my insurance). I am also in Pittsburgh going to Maggee as well. I am really anxious though because my BMI is also between 35-40 and they said that UPMC insurance is really strict. I will be so upset if I'm denied!

Anyway, glad it worked for you. Let me know how the op goes. :thumbup: