Concerned About BMI Requirement...

So, I have BCBSNC.  I know they have a BMI requirement of 50.  I have no co-morbs, really.  However, I'm getting a sleep study done, and I'm actually hoping I have sleep apnea diagnosed (last sleep study in '08 was inconclusive).

I saw another person on the board say that my surgeon (Dr Sudan) has not seen BCBSNC approve anyone under 50 for the DS.  I have not met with Sudan yet (switching from an RNY surgeon, and waiting to get my first appt with Sudan).  So, there is no recorded weight in his office.  I'd started trying to make better food choices and try some things in preparation for my RNY, and I've lost 10 lbs or so.  Should I try to gain 15 lbs, or is it too early in the game to do something that drastic?  I hate to do that!  Really, really hate to... but if it'll help me get approved, I wonder if it's something I should do.  And does that even work?  Will they question my sudden weight gain? (PCP has lots of weight records for the year already)

I read this link on dsfacts about getting approved.  The list of comorbs here are much longer.  I see, for example, that anemia is listed.  Just curious if anyone has been able to get approved based on these kind of "fringe" comorbs.  Or, do the comorbidities vary by insurance company?

Looking for any advice here... I'm a bit paniced that if I don't do something to be proactive here, I'll lose out on getting this surgery covered.

Thanks
Nic

I hate to be negative but my understanding is that BCBSNC will fight you tooth and nail for a history of 50BMI over several years (documented) and they have very deep pockets. I hate them! See what your particular policy states and see what BCBS's fine print says about qualifying and their appeal process. You could go ahead and get yourself a professional insurance advocate to help you out.
 
--gina

Oh boy... not good!  I don't know a thing about insurance advocates, and I can only find two companies in NC that do this.  Fortunately, one is only about 30 minutes away.  Any idea how expensive these types of companies are?

And here I was feeling pretty lucky to have BCBSNC!  They are great with everything else... even covering RNY, they pay for everything ($250 deductible), and no pre-op diet.  I just don't want the RNY. :(