BMI < 40 ?

Got a question that maybe someone knows the answer to.  My BMI is less than 40 (38.7).  I have high blood pressure, high cholesterol, and GERD; all of which are pretty mu*****heck due to medications.  I want to know if anyone has been in my situation and still got approved?

My insurance company refers to some 1983 Metropolitan Life weight charge to determine if you are at least 100lbs over weight, which according to that table, I am.  My paperwork has just been submitted for approval last week and I'm anticipating a denial b/ca of the meds controlling my comorbidities.  So, like I said above, I'm looking for some hope !!!!

Brian

Brian,  I have BCBSNC and qualified without comorbidities due to my BMI, so I don't have words of hope for you regarding your situation...I am just wanting to wish you lots of luck!  Hope you are able to get the approval you are wanting and are able to move ahead soon.  Best wishes!

Brian,

My wife had RNY in November of 07 with a BMI of 37.  She had diabetes, HPB, and GERD.  She had no issues with insurance.  It depends on you insurer, but given your comorbities I'm thinking you may be ok. 

Good luck

Jason

My BMI was above 40.. and I have BCBS.  BUT.. their policy is if you have comorbidities then you are lilkely to be approved.  I wish you luck in your wls journey.  :)  Keep us posted!

Brian,

Have you ever been tested for sleep apnea?  If you have a  BMI of less than 40 then a lot of insurance companies want you to have 2 co-morbidities. Blue cross blue shields likes the diagnosis of High blood pressure, sleep apnea, and diabetes. I think Jason said his wife had diabetes so that is probable what approved him.

Good luck. If you are denied?  ask the dr about being tested for sleep apnea. A lot of people have it and dont know it.

Tamara

Hi Brian,

Take a deep breath and sigh a deep sigh of relief. The standard is generally that if you have no comorbidities, you need a BMI of 40 or more. However, if you have one or more comorbidities, such as high BP, high cholesterol, GERD, sleep apnea, etc... you only need a BMI of 35 or more. So from that perspective you most likely meet the requirements and then some because  you have a BMI over 35 and multiple comorbidities.

I look forward to your post telling us that you've been approved.

All the best,

I hope you are right.  I'm just worried because when I read the qualifications to get approval from Cigna, it said that if you had a BMI less than 40 you could get approved if you had comorbidities that could not be controlled with medication.  I have high blood pressure, high cholesterol, and GERD.  But they ARE all controlled with medicine.  I guess I'll just have to wait and see.  Say a prayer for me.  Thanks.

I had a BMI of 35. I actually had to gain 5 lbs to have my insurance company pay for it (just went to McDonalds everyday and here came the extra 5 lbs!) I had Comorbids of high blood pressure and Metabolic X Syndrome. I have Tricare Prime and they paid for every penny of it. Best of luck to you!!!

Was your high blood pressure controlled by medicine, mine is.

They also listed metabolic syndrome on my paperwork, but I don't know what that is. 

Other than those two, did you have any others?  If you can let me know about your BP I'd appreciate it.

Thanks....Brian