Not one but TWO insurance hiccups. :(

First: Almost immediately after my doctor's office submitted for pre-auth from the insurance company, my husband lost his job. Due to my diabetes, we plan to continue COBRA coverage for at least a couple of months until his new coverage kicks in (thankfully, he has already found a new job). I was hoping to have surgery before the end of the year. Obviously, this complicates me, and I wondered if the looming end of coverage wouldn't influence the pre-auth decision (and not in my favor!). I would hope that is illegal and not the case, but I don't trust insurance companies at all really. So yeah. That sucks. 

Now: Today I confirmed with BCBS that they denied the pre-auth, based on my BMI being below 50. It's 49.4!!!! The rep on the phone said no additional documentation is needed or could help, because there's nothing that changes that. I saw this coming, of course, but it's still frustrating. 

I'm waiting to hear what the doctor's office will do. The decision was just made by the medical review board today, so they haven't gotten the official word yet, just a message from me. I know that there's some sort of appeal process, but I don't know how that works, what it will entail, or what my chances of success are. Not the good news I was hoping for, clearly. 

Trying to stay positive and hope there is a way that it can all work out, but this is not what I was hoping to hear. :( 

Are you sure about your height?  I was actually 1" shorter than I thought I was.  Most people fudge up their height just a bit and tend to get shorter as they age too.  Confirm your height.  If you are just 1" shorter, that will get your BMI where it needs to be.

I agree with the previous poster about height - have your doctors office check your height, the older/heavier I get the shorter I seem to get as well.  I'm not sure if it's my big butt pulling my spine down or my weight compressing my bones or what but I'm definitely shorter nowadays than when I was thinner.

Also, DON'T BE DISCOURAGED!  I cannot say this enough.

What are the odds that your husbands new insurance is as good as or better than his old insurance? I know you want surgery by the end of the year but it's always reassuring to have your plan B in place, right?

A little inspiration for you -  I was approved (on first appeal) for a lap band in 2008 with a BMI of 39 and no co-morbidities even though my insurance required BMI >40 or >35 with 2 co-morbidities. Doctors office wasn't sure how I got approved but I did.  Even more astounding - a week ago I was approved (on first appeal) for a revision to a DS by an insurance plan that says only one surgery per lifetime and requires 6 months of physician supervised diet records that I did not have. Again, surgeons office was shocked as they never thought I'd get approved.  It happens.

So, there is hope. You have nothing to lose by trying. Don't take no for an answer and don't listen to anyone who tells you there is no way.

You don't HAVE to stand up THAT straight......  And you can take your shoes off.  And you can collapse your ankles inward as they measure...

Your surgeon can appeal it by phone as well which is taken very seriously when your surgeon takes the time to do that. 

Thanks everyone for your replies. 

Unfortunately, I am sure about my height. They verified it at the surgeon's office. I may have tried to slouch a little anyhow, but I'm a little over 5'4" to start so it didn't help much. I was barefoot, though if they'd let me wear my shoes, maybe I'd have weighed those four extra pounds, ha!

The surgeon's office says my only options now are to appeal or choose a different procedure, and I know I don't want a different procedure. 

I don't have the details on what our new insurance will cover, but of course I'll look into that if that what it comes down to. 

We'll see what happens next--I'm definitley hanging in there, and I'm not going to be pressured into another type of surgery over it...Just have to go one day at a time and see what happens.