Insurance Approval?

Has anyone heard of someone being approved for surgery if they had a BMI >40 but not the regular comorbidities.  I have prehypertension and pain in my weight bearing joints and the skin rashes and of courses the shortness of breath, but don't have the full blown high blood pressure or diabetes or anything like that.  Just wondering how hard it's going to be to get approved.  Would really love some input.  Thanks!

I didn't have any current comorgidities but had enough "potential" ones that I guess that pushed me through.  I have a family history of colon cancer and diabetes even tho I didn't have either.  I had gastric reflux, joint pain, high cholesterol and that is about it.  Anyone that is obese has comorbidities as pre diabetes, pre colon / breast cancer, heart problems, peripheral swelling (in the legs and ankles), etc.  I had my PCP write a letter to my surgeon of my current health status (which I was really healthy as a horse) but being obese, I had pre comorbidities.  I had a psychological evaluation before submitting my info to insurance.  So, before submitting to insurance, I had a recommendation from my PCP, psych eval and surgeon eval.  Since I sent all this info in the first time, I was approved within 4 days.  A lot of times, if the insurance company doesn't have enough information on you, that is why they deny it and you have to then go back and gather up more info for your appeal.  I have AR BCBS.  So, my advice is to get as much written info from as many Drs as you can, recommending the surgery for you and be sure they list every pre comorbitiy that you could possibly have.   Goog luck.  Which surgery are you having? Angela

I have United Health Insurance and was approved in a timely manner.  I had letters from my primary care physician and surgeon recommending WLS. I sent in documentation for the last five years from my primary care physician proving obesity for those five years and the different treatment attempts. I called the insurance company asking exactly what was needed for approval.  My insurance required a letter from the physician, a BMI over 40, and five year history of weight loss attempts if there is no other diagnosed health risks like diabetes, hypertension, etc. I believe my timely approval occurred because I asked the insurance company what was needed for approval and provided everything that they asked.  Good Luck!   Heather

           It really depends on your insurance! you really need to call them and ask what are the requirement's for WLS. And do you cover it and if you do what types do you cover. then it will just go from there. ask them what co-morbids do they require to consider you for the WLS. It really depends on the insurance and the surgeon that you choose.               I have BCBSIL and they required me to have 3 Co-Morbids plus 5 years of weight gain and trying to lose the weight and then 6 month's of supervised nutrition and dr's visit's. I send in my paperwork on tuesday this week. I hope this help's you. Oh my Co-morbids are high cholesterol, Sleep Apena, flealling of the arms and legs while sleeping and my BMI is 39.1. Like I said I hope all this help's. Keep all updated. and  GOOD LUCK!!!!!!!!! 

Oh and I didn't mean to impose on the Arkansas board I'm from Harrison. Just make's me feel at home on here.  Thanks

Thanks for all the info everyone.  My insurance is Medicare and Medicaid,  I think some people have a lot of problems with them.  I'm already on disability, but not for my weight.  I'm hoping to have the lap band but will wait to see what the surgeon recommends.  I'm just starting this process and so far only have confirmation that my PCP will help me, whatever it takes. Also, I am pretty positive my pshyciatrist will help.  I am looking at all the info packets out there to see what all I have to do so that I have it all together at one time for the insurance company.  I'm hoping and praying that I will do it all correctly and it will fall into place.  Wish me luck.  I need all the energy I can get to raise this WILD 1 yr. old I have at age 39 and still be around to see her grow up.  I never expected to be a new Mom this late in life.  My sixteen year old didn't expect it either. LOL Thanks!