Got rejected from EMMC for being too health

I am so upset right now I don't know what to do. I finally broke down and asked my PCP for a referral to Bangor and just called EMMC to find out why I haven't heard anything. Well they told me I was rejected because I was too health. Yet I am 225lbs over weight. I have medicare/mainecare and they said I need to have at least 1 co-morbidity to go along with my extremely high BMI. I don't have diabetes, sleep apnia, high blood pressure. I do have arthritis in my back and knees really bad in my back, I do have high cholesterol. I am really beside myself, I don't know what to do. They said that being extremely obese is not enough reason to get approval for surgery. Has anyone gone through this or something similar? Does anyone have any advice on what I can do to have this surgery?

Any help/advice would be greatly appreciated.

I would make sure that the paperwork submitted to EMMC mentioned the arthritis and high cholesterol.  That's all I had for comorbidities and I was approved through the Augusta program with no problems.  You could also check with the Maine Medical program in Portland.  I think that Medicare only pays if you go through a Center of Excellence, which currently is only Bangor or Portland (I don't think Lewiston or Augusta are approved officially yet).  Just talk to them and make sure they have all the facts.  Good luck!

I'd ask for an appointment to discuss the issue. Bring all your paperwork/edical records. Arthritis and high cholesterol are co-morbidities. Use them.
It also depends on what your PCP put on the form. Ask for a copy.

Good Luck!

Also who did you talk to?  Was it just the office staff?  I'd ask to speak to the program coordinator, Lyn Bolduc, she's awesome.  You need more information about why.

Good luck!
Tami

Thanks for all the advice. I did speak to someone at EMMC again today and they referred me to Lynn Bolduc but she's out till next week. So hopefully she can help me out with this.

Thanks again guys

I had no comorbities and my BMI was just at 40.  I had my surgery in Lewiston.  Have you been tested for sleep apnea?  About  70-80% or candidates for gastric bypass have Sleep apnea and don't know it.