Denied surgery for a BMI of 34.9 with comorbidities

My insurance company denied my gastric bypass as it requires a 5 year weight history of a bmi of 35 or higher with co-morbidities, 40 or higher without. I was one pound off of meeting the criteria. I have asthma, sleep apnea and am on blood pressure medication, but am still starting to have cardiac issues.  My cardiologist is furious that I was denied.  Has anyone had any luck appealing the decision of their insurance company?

I'm planning to fly to Mexico to have the procedure out of sheer desperation but I would much rather have it done at home!

Insurance companies have guidelines and normally don't bend them.  It is sad that you were so close, but I am glad that you are able to fly to Mexico and get this taken care of.

Yes I am fortunate that I can do that, even though it scares me to death.  I have been researching like crazy but it's hard to be 100% confident that I'm picking the right surgeon!

I'm sorry that they denied you.  Normally i try to dress in clothes that are lightweight because I want my scale to be as accurate as possible.  It's sad to think that maybe a pair of boots or a heavy sweater could have pushed you up one pound and you could have been approved.  

I have heard some really good things about some of the surgeons in Mexico.  I'm putting their plastic surgeons on my list to look into when the time is right for that.  

Good luck!

Thank you Deanna....Do you have a surgeon you would recommend in Mexico by chance?

I'm sorry,  I don't.  I had my surgery here in the states. Though I believe you will find some self pay people on OH that may be able to help you.  

Post a new topic for recommendations for surgeons in Mexico - you will get plenty of recommendations.  Not everyone might see this part of your conversation thread.

I would also ask your cardioloist to appeal and see what happens. 

I can only say WTF, how screwed up is this. 

I used Dr. Jesus Martin Lopez through a package deal with Bariatric Pal. They have other surgeons as well and you can talk to them and skype etc before making a choice. I could not have been more satisfied.

Check this out 

http://www.obesityhelp.com/forums/mexico/

Thanks again....I have been reading reviews and am torn between Dr. Ramos Kelly and Dr. Fernando Garcia.  Both doctors seem to have good reviews, but Dr. Kelly seems to have more and his price is quite a bit higher.