Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BMI 39-bcbs of north carolina



Recommended Posts

I am going to Dr. Enochs seminar on July 2. I have a BMI of 69 ( weigh 455) and no comorbidities that I know of. With a higher BMI do you need the other?

Thanks,

Renee

Plum, for most insurance and surgeons, the "line" is a BMI of 40 or higher does not require any comorbidities. You are well above that line so you wouldn not have to worry about whether or not you have any comorbidities....except to know that you should be able to kiss them goodbye in the future.

Good Luck

Share this post


Link to post
Share on other sites

Plum, for most insurance and surgeons, the "line" is a BMI of 40 or higher does not require any comorbidities. You are well above that line so you wouldn not have to worry about whether or not you have any comorbidities....except to know that you should be able to kiss them goodbye in the future.

Good Luck

I don't know about that, I think if your BMI is above a 50 you will need to have comorbidities. I would check to make sure.

Share this post


Link to post
Share on other sites

I don't know about that, I think if your BMI is above a 50 you will need to have comorbidities. I would check to make sure.

Parrothead is correct, you need comorbidities for BMIs under 40.

Share this post


Link to post
Share on other sites

Well today I went for my psych eval, all went well, last about 45 min, nothing to it at all. Now I'm just waiting I guess for insurance approval. Wish me luck and I'll keep you all posted.

Share this post


Link to post
Share on other sites

Parrothead is correct, you need comorbidities for BMIs under 40.

Yes, parrothead is correct about having to have comorbidities if your BMI is under a 40, but if it's more than a 50, I think that's another story. I believe you have to have comorbidities as well if its over 50.

Share this post


Link to post
Share on other sites

Thank You all for your insight. I am lucky, and as of right now I have no comorbidities. I go to the seminar on thursday. Hopefull Dr.Enoch and his staff will have the answers my questions. Thanks again!

Share this post


Link to post
Share on other sites

Yes, parrothead is correct about having to have comorbidities if your BMI is under a 40, but if it's more than a 50, I think that's another story. I believe you have to have comorbidities as well if its over 50.

I do not think so, it wouldn't make any sense anyway. If you don't need comorbidities for a BMI of 40 it makes no sense that they would require comorbidities for an even higher BMI.

I wonder if you are thinking about something else, some ins co's won't band someone with a BMI of 50 or greater and then some won't do DS until you are a BMI of 50. Could you be thinking of something along those lines?

Share this post


Link to post
Share on other sites

I do not think so, it wouldn't make any sense anyway. If you don't need comorbidities for a BMI of 40 it makes no sense that they would require comorbidities for an even higher BMI.

I wonder if you are thinking about something else, some ins co's won't band someone with a BMI of 50 or greater and then some won't do DS until you are a BMI of 50. Could you be thinking of something along those lines?

Maybe that is what I'm thinking about. Thanks. I hope all goes well for her, like you said it wouldn't make sense for them not to do it. I do think it depends on ones insurance.

Share this post


Link to post
Share on other sites

I went to the seminar last night. Angelica answered all of my questions. It use to be that insurance would deny you the lap band if your BMI was too high (bcbsnc) but not anymore. Also I just need 2 years documented weight history. I was torn between RNY and the lapband. After much thought, and prayer on my part I have decided for the band.

Share this post


Link to post
Share on other sites

I went to the seminar last night. Angelica answered all of my questions. It use to be that insurance would deny you the lap band if your BMI was too high (bcbsnc) but not anymore. Also I just need 2 years documented weight history. I was torn between RNY and the lapband. After much thought, and prayer on my part I have decided for the band.

Good for you, I hope all goes well. Keep us posted on how things are moving along for you. I'm still waiting for an approval from my insurance company too. I'll keep you all posted as well.

Share this post


Link to post
Share on other sites

Good for you, I hope all goes well. Keep us posted on how things are moving along for you. I'm still waiting for an approval from my insurance company too. I'll keep you all posted as well.

Wonderful! That's the good thing about BCBS...they only want two years weight. Good luck with all of the preliminary things. Please udate me as you move along. Congrats! :eek:

Share this post


Link to post
Share on other sites

Hello, I have BCBS of NC and I am having my surgery done in Lumberton (Southeastern Regional Medical Center). I guess it all depends on the person and the situation, regarding how long it takes for approval. I was approved the same day my doctor sent in the paperwork. My BMI is like 46.6, and I don't have any co-morbidities. I use to get the B12 shot back in 2007 for about 6 months and lost 45 lbs. I had to stop b/c I became pregnant. I had my son Aug. 08 and gained the weight back plus 20 lbs. I breastfed so I could not continue B12, I went to a seminar at SRMC in May and decided to see if I qualified. After doing my pre-testing I was approved on July 1, and have a date for July 31st.

Our plans changed as of July 1, 2009;

$600.00 deductibles

$60.00 co-pay for specialist

$25.00 co-pay for primary

Good Luck to all and pass the word there is an surgeon in Lumberton!!! (Dr. Barry Williamson):(

Edited by cb0828

Share this post


Link to post
Share on other sites

That is awesome, I am waiting to here from the docotrs office about the preliminary. I guess they are trying to see what insurance will pay. Not sure what they do, they have my insurance information which I gave them when I went to the seminar. Is this when they are asking for an approval. I am not sure but I am tired of waiting(LOL) it has only been a week and couple of days. I am just curious and ready for the ball to get rolling.

Share this post


Link to post
Share on other sites

Hello, I have BCBS of NC and I am having my surgery done in Lumberton (Southeastern Regional Medical Center). I guess it all depends on the person and the situation, regarding how long it takes for approval. I was approved the same day my doctor sent in the paperwork. My BMI is like 46.6, and I don't have any co-morbidities. I use to get the B12 shot back in 2007 for about 6 months and lost 45 lbs. I had to stop b/c I became pregnant. I had my son Aug. 08 and gained the weight back plus 20 lbs. I breastfed so I could not continue B12, I went to a seminar at SRMC in May and decided to see if I qualified. After doing my pre-testing I was approved on July 1, and have a date for July 31st.

Our plans changed as of July 1, 2009;

$600.00 deductibles

$60.00 co-pay for specialist

$25.00 co-pay for primary

Good Luck to all and pass the word there is an surgeon in Lumberton!!! (Dr. Barry Williamson):)

Congrats to you. Do you have to pay anything up front before you have the surgery?

Share this post


Link to post
Share on other sites

When you went for the seminar and the office sent in the paperwork, how long did it take for them to contact you. I went to the seminar and the paperwork was sent in the same day. I guess I am on pins and needles because I want this so bad. I was trying to get all of these appointments out of the way since we are out of school right now. Looking at about three more weeks before I return to work. I guess i am just rushing the process. I have been so pumped up about this since I attended the seminar. really just want to be healthier and not so heavy. I work in a modified year round school. Next month we go back around the 16, actually it is less than three weeks the more I think about it.

Who did you decide to go through to do your surgery?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

    • Jenopolis

      Had a sleeve in 2017, lost over 100 pounds. Had a DS surgery this year (2025) for more sustainable weight loss. 🤞
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      The 14th was my day. I am home and recovery is going pretty smooth. They even let me walk out of the hospital. Picture of me in recovery curtesy of my boyfriend lol. 

      · 3 replies
      1. DaisyChainOz

        Glad it went well!! Wishing you a speedy recovery and wonderful success!! 🤗

      2. buildabetteranna

        Thank you ❤️

      3. Selina333

        Neat you have a pic of this day! I was sooo happy to get my surgery. It was well worth it! And I'm not even near my goal. I had surgery Dec. 2!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×