Insurance.. Blah
I just finished my last weigh-in because my insurance required a 6 month pre-surgery doctor approved diet. I talked with the surgery coordinator Thursday and she said she would be faxing all the paperwork to insurance and we should hear something back sometime this next week. I can't help but to be nervous. She is concerned because she also had to submit my last 3 years weights and per insurance, they should be over 40 BMI. 3 years ago my BMI was 39.8. Does anyone have any experience with their insurance approving/denying based on the BMI being that close, but not right at 40? Any thoughts and prayers would be greatly appreciated. I don't know if I should be scared, nervous, happy, depressed.. I kinda feel all that right now and it's hard not to binge eat from the worrying. Thanks for any and all support!
I always say with insurance companies...a lot depends on whose desk it crosses... so good luck in that department. Don't know if you have high blood pressure, sleep apnea, or diabetes but if you have those co-morbidities the requirement is only usually a 35 BMI... one 39.8 reading in 3 years would seem pretty harsh for them to deny...
Cynthia 5'11" RNY 7/23/2014
Goal reached 17 months. 220lb Weight Loss
Plastic Surgery Dr. Joseph Michaels - LBL and Hernia Repair 2/29/16, Arm Lift, BL, 5/2/16, Leg Lift 7/25/16
#lifeisanadventure #fightthegoodfight #noregrets
I thought I had already replied to you, but here goes again. I agree that it does depend on whose desk it crosses, but I am hoping whomever gets it, is having a blessed day! :D I do not have high blood pressure, but I do have sleep apnea. My coordinator said it isn't considered a co-morbidity due to the fact that my "score" was only 13, but I still have to use a CPAP.
I just finished my last weigh-in because my insurance required a 6 month pre-surgery doctor approved diet. I talked with the surgery coordinator Thursday and she said she would be faxing all the paperwork to insurance and we should hear something back sometime this next week. I can't help but to be nervous. She is concerned because she also had to submit my last 3 years weights and per insurance, they should be over 40 BMI. 3 years ago my BMI was 39.8. Does anyone have any experience with their insurance approving/denying based on the BMI being that close, but not right at 40? Any thoughts and prayers would be greatly appreciated. I don't know if I should be scared, nervous, happy, depressed.. I kinda feel all that right now and it's hard not to binge eat from the worrying. Thanks for any and all support!
Hi
I just got approved by Harvard Pilgrim last week. My BMI is under 40 but I have two, actually 3 now, co-morbidities...high blood pressure, type 2 diabetes, and sleep apnea. I had no problem.
Every insurance is different. Some of us here have really good plans and others - not so much. All depends.
Fingers crossed for you. I hope they approve. You've worked hard - congrats.
Jan
Height 5'4 Starting weight: 225 Surgery weight: 216 Goal Weight: 135 Surgery date: 1/23/17 Portsmouth, NH
The little engine that could.....
Mustang - my insurance required bmi of >35-39 and one co-morbidity (used to be two co-morbidities in this range). Over 40 bmi needs no co-morbidities. Hopefully (!!) you have at least one.
Crossing fingers and toes for you!
I've been fat, and I've been thin - and thin is better.
There is a better way. --Alaine of Lyndar
--------------------------
HW: 234. SW: 228 (18 June 2015). GW: 137. Specs: 50ish, 5'4"
WHOOOPPP!!!! CONGRATULATIONS! I've been crossing my fingers and hoping you'd get good news - doing the happy dance for you! :)
I've been fat, and I've been thin - and thin is better.
There is a better way. --Alaine of Lyndar
--------------------------
HW: 234. SW: 228 (18 June 2015). GW: 137. Specs: 50ish, 5'4"
Thank you so much!! I'm so excited! Fortunately or Unfortunately.. I can't finish my pre-surgery appointments until Feb 17, so my surgery probably won't be until end of February/beginning of March. I guess that's fine, but it's the waiting that is going to be hard! I am so ready for this change in my life! :D