I don't have sleep apnea, will I be refused?

I had a vsg in 2011 and i wasn't very successful with it. I am looking to have a revision of a DS.

i am going through the program now and did the at home sleep apnea test and it came back showing I don't have it. I did have it back in 2011 before my vsg. But the respiratory therapist and sleep doc want me to come in for an overnight test just to be sure and for more accuracy.

my bum is at 48. I have high bp but no other co-morbidities. Is it possible I can be denied for. It having any other comirbidities? I believe I have gerd but won't be able to discuss that until I see a surgeon

It all depends on your insurance, but most insurances have the following guidelines (or something similar):

• BMI of 35 or more with comorbidities like HTN, diabetes, sleep apnea, just to name a few
• BMI of 40 or more with or without comorbidities

Just give your insurance a call and ask.  That's what I did.  I called and asked what the guidelines were just to make sure I would qualify before I ever saw a surgeon.

Hope this helps!

I did the same thing. I called my insurance company and just asked them. Easier to get the answer than to worry over it. Good luck!

Every insurance situation is different. What was covered for one person may not apply to you, even with the same insurance company.

Your best bet is to call the customer service phone number listed on the back of your card and ask what their guidelines are.

I never was tested for it and was approved. I do agree with all of t he other poster's saying that it all depends on your insurance.

If your BMI is over 40, you may qualify without co-morbidities.

In addition to this, you should make sure your insurance company covers multiple bariatric surgeries (some have a one time only policy) and that they cover the DS (some don't).

Good luck!!

Yes, I will call and confirm. The detailed guidelines I have state bum of 35 or more with comorbidities or 40+ with no comorbidities.  But double confirmation will help. 

I guess I am nervous about starting this whole process again. thanks !!

With a BMI at 48, you qualify for WLS all over again.  Most insurances will cover you on just that.  It's those with BMI's under 40 that need a couple of comorbs.

My insurance, Blue Cross/Blue Shield, did not cover my revision from lapband to RNY because they will only cover one WLS per lifetime, with no exceptions! I would definitely call them to verify what they will cover. By the way, most surgeons have a finance program available.