Proof of BMI at or above 40 for 5 years?

No that's not bad information. I had to have my BMI over 40 for at least 5 years. I didn't have to prove anything it was just something I was asked and had to show I have been obese for some time and that it wasn't just a new weight gain.

It really is going to depend on your insurance. Insurance companies vary and require different cir****tances to be met before they will approve you. I have heard of some requiring your BMI to be over a certain number, there is a way to prove what your BMI is. A lot of insurance companies really don't want to pay for WLS, so it may be hard if you don't have any weight related conditions. Though I would talk to your doctor about it.

My insurance required a weight history for 5 years which essentially gives them a BMI history since they have my height info as well. I have seen many people here say they had to provide the same thing.

As for apnea, if your insurance requires you have at least one co-morbidity, they're going to need proof. The test will prove if you have it. They're not going to accept that you "might" have it.

You can call your insurance and ask them exactly what the requirements are for surgery. I understand some only require a co-morbidity if BMI is below a certain number.

My insurance did not require a 5 year history of BMI over 40. They required that my BMI at the time of consultation be over 40 or over 35 with co-morbities and that I have 6 months of "medically supervised weight loss visits" prior to surgery (plus the usual evaluations done by the Bariatric surgeons).

Yup- each company is different. To my mowledge I didn't need a 5 year history.

You need to call the number on the back of your insurance card for these answers. We can't give you answers with any certainty - the insurance company can.

Not many have that requirement, but some do. I have seen about 4,852 different sets of stipulations. On top of insurance requirements, surgical programs have an entirely different set of conditions of their own.

Take a breath and make a phone call to find out what your requirements will be.

I put off surgery for many years because of incorrect information about requirements. I listened to others instead of finding out for myself. Check with your insurance company.

I have an EPO which means I don't need referrals to see specialists as long as I use "in-network" providers. There are 3 bariatric specialists in my area that are in-network and 2 are father and son. I registered for their in person seminar, which is 3 hours long, but wanted to confirm they accepted my ins. Note they were on my EPO's provider list. Called twice; 1st call I got a "I think so" answer which is odd, 2nd call after being placed on hold for a long bit the answer I got was "yes our office is on your in-network providers list but we are no longer accepting your ins. company". It felt really odd and unprofessional. So I called the other surgeon's office and after faxing a copy of my ins. card they called me back with a YES THEY ACCEPT : )

Now what I find a bit different is they require me to attend the same in person seminar as the other unprofessional offices seminar.

We'll see how it goes, it's not to far out on 5/16.

I seem to get the run around from my ins. company over the phone as to what the pre qualifications are. This is why I thought finding a in-network surgeon would be easier so their staff would work with my ins. cutting me out of the middle man situation.

I understand this is a long process but is it usually one that has the patient running in circles without definite answer?

Some surgeons are justtsurgeons. Some are part of a large group that have registered dieticians and insurance coordinators working with them. If you are lucky to find one of those in your network, tgey can rwally help guude you through the whole process. The surgeons themselves just don't have time to do those things.