x-post: Tricare + comorbidities

I was excited Friday to find an email from my insurance company saying they approved the referral to my local wls clinic.  Just to call the clinic and have them tell me that they wouldn't even schedule the consultation for me because my BMI was too low.  And by too low, I mean, I'm just missing it by a few pounds.  But that is for the 35 BMI cutoff w/ comorbidities level.  My questions is, what all is considered a comorbidity?  I know the basic obvious ones like high blood pressure, diabetes, etc.  But I don't have any of those.  I do suffer from depression which seems to get worse the bigger I get.  I also have a lot of back pain and knee pain.  My knees make this weird creaking noise whenever I bend them.  I was told once that the cartilage between my bones might be wearing away.  ???  I don't know if I said that right.  I also occasionally have these awful chest pains that make it hard to breathe.  Nothing in particular seems to trigger it.  But it's always on the left side, and sometimes lasts for an hour or more.  My heart is fine.  I've had it checked.  My last episode was actually at my dr.'s office.  He wouldn't let me leave until it stopped and then sent me for a bunch of blood work that came back fine.  His conclusion was it was some kind of arthritis.  Also, I have a high family history of obesity, high blood pressure, diabetes, and heart disease.  So basically my question is, would these types of things be considered comorbidities?  Thanks for your help!

What about your family history of disease? Sometimes that can help. I didn't have any co-morbs either, but my BMI was right around 40. Diabetes runs rampant in my family and it was a pretty much given I would end up with it at the rate I was going.  On a separate train of thought...I know of AT LEAST 2 people who wore ankle weights to their weigh-in to 'make' the number. SERIOUSLY. Or ramped up their eating to gain on purpose.

If you have a BMI of less than 35 and NO co-morbidities then good luck with your search. I know that's not what you're wanting to hear but it is necessary. They're trying to get this procedure more commonly accepted by insurance. They need for them to see this as a medical response to a medical need. If they start doing these on people like you, then they will add fuel to the other guys fire that this is all cosmetic because they won't be able to both show AND PROVE that they some how "saved" you. They have to be able to show to even the dumbest of dummies the numbers and facts that say you were gonna die and now you aren't. Frankly I'm surprised that Tricare approved you with what you've submitted. The risk vs benefit factor must be there. For the record though, if you can prove you have some form of degenerative arthritis, that IS a co morbidity.

Indeed you should get documentation on your family history.  What about sleep apnea...have you had a sleep study done?  You mentioned your knees...have your primary doctor take xrays to see if you have degenerative arthritis, that IS a comorbidity.  Document acid reflux, your depression, ANYTHING that might be related to your weight and your health.  If you don't have any of it in medical records, make an appointment with your doctor for a total physical and let him help you.  Have you ALWAYS been just under the BMI requirements...or have you been above and then lost some weight?  That might be something they would look at too.