Anyone Been Approved w/out a 5 Yr MO Wght History when it was req'd?

Marie71
on 9/24/07 9:17 am - Somewhere In, NC

Has anyone been approved without a 5 year weight history of morbid obesity when their insurance company required it? I have documentation of my weight over the last 5 years, and although I was obese all those years, I was not what is considered "morbidly obese". Any help in this matter would be greatly appreciated! I have BCBS of NC State Employee.

Gigi23
on 9/24/07 7:34 pm - Haw River, NC

Hi Marie, I had UHC when I had my surgery. They required five years of doctor documented weight gain, not morbidly obese for 5 years, because I was not. We are switching over to Highmark BCBS Jan 1, and I'm wondering how that will affect my plans for a tummy tuck, when I had my surgery through UHC. Please keep us posted throughout your journey. We are here to support you and answer all your questions! Blessings, Diane

Through God ALL things are possible!

Lisa_W.
on 9/24/07 8:33 pm

RNY on 07/02/07

Marie, I also have BCBS State Employees insurance and I had 5 years but they weren't consecutive. We pulled from the 90's as well. My weight has fluctuated over the years. I even had my booklet from Weigh****chers back in 97 which they used. My surgeon's office tried to find 5 weights where I was at a 40 BMI. Good luck.

Marie71
on 9/24/07 9:22 pm - Somewhere In, NC

RNY on 01/10/08

Thank you Diane and Lisa for the information and your kind words of encouragement! I will keep everyone posted on my journey - my first appt with Duke WLS is October 19th!

Jennifer K.
on 9/24/07 10:34 pm - Phoenix , AZ

RNY on 06/20/06

I had BCBS PPO of NC I had the 5 years weight history but my BMI was WELL under 35 one year and was just under 35 another year... I did not have any of their comorbs (no high blood pressure, sleep apena etc). Obviously I was approved :-) I was denied and had to appeal 3 times and it took me 4 months... but I stuck it out!

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

Marie71
on 9/25/07 12:28 am - Somewhere In, NC

RNY on 01/10/08

Thanks Jennifer - looks like I might have to appeal as well!

Jennifer K.
on 9/25/07 6:33 am - Phoenix , AZ

RNY on 06/20/06

If you can get other Drs to write letters on your behalf that will help... my PCP and OBGYN were behind me 110%... I had been going to both for 3 years so it was helpful to get letters from them!

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

Anyone Been Approved w/out a 5 Yr MO Wght History when it was req'd?

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Anyone Been Approved w/out a 5 Yr MO Wght History when it was req'd?