Will ins pay with no comorbidities?
(deactivated member)
on 7/21/07 8:38 am - WA
on 7/21/07 8:38 am - WA
Hi all! I'm new and very excited about wls and ready to make the commitment to my health! I start a new job Monday and won't have benefits for 90 days and at that point will start trying to get RNY covered (though I know my dental coverage won't do surgeries for a certain time period so I don't know if health insurance is that way?) Anyway my problem is that while I am "super morbidly obese" with a BMI over 54, I am only 25 and don't really have any health problems related to obesity yet except for back pain. I have an extensive family history of hypertension, high cholesterol and diabetes (my biggest fear of all). Is there any chance I can get insurance to cover it? I wouldn't mind paying out of pocket except I just graduated from college and between student loans, my car and credit cards I'm about $100,000 in debt (and I'm only an RN and my husband is a restaurant manager - we're not rolling in money!). I'm not sure which insurance company I will be dealing with yet.
Thanks for any insight!
From what I've read, the co-morbidities really come into play when you have a low-BMI (between 30-35). At a BMI of 54, and a history of failed diet attempts, you should be able to be approved; I say SHOULD because as you can see from the board, what insurance companies SHOULD do and what the DO do, are two very different things. If you need to write a letter, I would definitely include the family history as what awaits you down the road, using SPECIFIC relatives.
For example (JUST an example), "My father was diagnosed with heart disease at forty; he died at fifty-four, after two massive heart attacks, and a long bout with cancer. My grandmother died of pancreatic cancer. My mother has hyperlipidemia, hypertension, and type two diabetes. These are things that will surely affect me as I age if this surgery is not approved. "
Just one woman's humble opinion.
(Hi/DoS/CW/GW) 335/320/243.5/174 (-91.5)(total lost) in 18-20 dependent on brand!
I'm more than half-way there! :) (68.5 pounds to go)


I'm more than half-way there! :) (68.5 pounds to go)


I too was afraid I wouldn't be approved. I have a BMI of 46 and no diagnosed Co-morbities. No history of weight loss diagnosed by the doc. I just don't go to the doc except for a few sinus infections.
My surgeon required I submit the past 3 yrs of doc records, I requested 5 yrs. I wrote my own letter stating my medical facts and family history so they (insurance) would have that picture. I didn't need a letter from my PCP. No supervised diet ect. I was approved in less than 2 weeks.
First Surgeon visit is Monday the 30th!! I'm so excited! My Hubby took the day off to get the scoop with me! I can't wait!! I was told surgery would be scheduled in Late September or early oct!!! WOOHOO!!
I wish you well on your journey, I remain a little skeptical in regards to the final outcome as I'm just waiting for a block to be put in my way. But remain hopeful in a cautious way!
