5 years??

I have constantly struggled with my weight, and for the past 3 years I havent had a dr's visit because, what is she going to say, you need to loose weight? I am concerned about fulfilling the 5 years requirement. Does it have to be 5 years of 40 BMI, I just recently hit 40 after bouncing up from a recent weigh****chers loss, (started at 272, dropped 10 and bounced 20, story of my life...) 3 years ago my dr. put me on phentremine, but I stopped because it made feel jittery. That was about the last time I went. Please help.

I was told that if I was missing a weight for one of the past years, that I should get dates going even further back into my history to prove long-time obesity.  You might want to include the past 8 or so years of weight histories, unless you visited a specialist or something that took your weight within the past 3 years.  Also, you mentioned you were on weigh****chers, did you go to the meetings?  If so, you can use the weight records from those. You don't have to be over BMI 40 to have WLS, so I do not think you will need to have all your weights be a BMI of at least 40.  You only have to have a BMI of 35 to have WLS. Also, it's important to have a good relationship with your PCP and be comfortable with him/her because you may need them to do your physical pre-op and fill out orders for labs post op.  It'd probably be helpful to have a trusting relationship with them so you can get help from them during your WLS journey.  A good PCP makes a big difference - mine supported my WLS decision and even helped me look for more documented comorbidities to submit to insurance.

I am just worried and kicking my self, I know I have sleep apnea but I never got it diagnosed because it is related to my weight, and I was embaresed. I wish I would have now... I also don't want to spend 1000 dollars on stuff not relating to the surgery (nutritionists and stuff). I am going to go through with the initial appointment and then have a conversation with my dr, to gather the appropriate documents. I wish the weigh****chers would qualify as the supervised weight loss plan, but the dr. didn't tell me to go. *sigh* how frustrating.

Hello
I have asked this question before as well. They want to see 1 note from each year from the past five years. I only have 3 yrs myself. BUT if you have ben o a clinic an ER visit or anything that will be fine. The just want to se your weigh. i have seen ppl say a photo with a date stamp will do as well. As far as the sleep apnea once u start your process they ma order u to do a sleep study.

Blast! I have none of that, curse me for avoiding the dr.

You must have BCBS? They are the only insurance I have found so far with such ridiculous stipuations for surgery. If not- please enlighten me to your insurance so I don't feel so lonely in the woods with the ugly wolf. As far as your weight- all I can say is to try to get approval. This 5 year requirement has been proven to be a whimsical requirementand is often overturned in the peer review depending on what state you live in. I am in AZ and Gary Viscio told me that there have been many cases in AZ where the peer review has overturned the denial if the 40+ bmi is the only thing standing in your way of the surgery.  I would suggest contacting Gary- he is a really brilliant guy with a good heart- he isn't going to blow smoke. Some other places you might have been weighed was if you joined a gym? Otherwise- just have your doctor state that you have been an obese adult for five years or longer in really strongly written letter. I am sorta in the same boat as you. After I had my daughter 8 years ago I was overweight- then I slimmed down after staving myself on the ever-so-popular cabbage diet. I lost 20lbs and then gained it all back  plus someright away. This happened many times on different diets - WW, atkins, blah blah blah. Over the course of several years- now I have decided WLS is the only solution for me- I have had a BMI of 40+ for the past three years on paper and I am hoping and praying that my deteriorating health problems and my dedication during the 6 month supervised diet will show BCBS enough about how much I need/want this surgery.  I hope that gives you some new hope on the 5 year BMI.

Yep, I am BCBS of Illinois (in California ??) (who ever said they are the easiest to get approved on should be shot). I am thinking of having the dr. write a letter that shows a history of continuing weight gain. The only problem I am forseing is that I just reached the magic 40+ bmi at my last physical, do I have to suffer for 5 years at this weight before they will approve the surgery?!. I have the seminar appt in Oct with Dr. Boone (finaly after a week of leaving messages. supposedly best doc in Fresno). We will see what happens as I go through the motions. I am just hoping that my plan doesn't change for next year to exclude WLS, I will scream if I do all this work for that to happen. Here is my next bump, the insurance wants me to submit medical records, but the Dr.'s office wants the insurance to request them, how do you get through that one?

Yeah- BCBS is I would say the hardest- but at least we are more fortunate than some in that they even cover it at all.  Gary Viscio will tell you that if you are worried your policy might change to exclude the WLS you could ask them to give you approval pending the completion of your six month diet history- or ask your employer when open enrollment is so that you know how long you have to get that started. As far as all the other stuff- while I recognize you do have some stuff working against you- just try to stay positive and do what you can to gather everything that these fools want. They can only say no for so long rigth?

You should still have a sleep study.  I was told it could be dangerous to have undiagnosed sleep apnea after surgery.  Most surgeons require that you be on a CPAP 2-4 weeks before surgery if you need it.  My sleep study was mostly covered by insurance.  I have a $300 deductible so that's all that it cost to get my pre-op stuff done.  I ended up just having slight sleep apnea that doesn't require a CPAP. For the medical records, I contacted my PCP directly to get them.  I just called them, asked for the medical records person, and told them I needed my weight records going back to 2002 (you may want to go further since you are missing some).  Call any other place that you were weighed and ask for them to write down the date that you came in and your weight.  I also knew that I began having high blood pressure as I got heavier, so I also had them write down my blood pressures on each of those dates so I had concrete proof that my weight was causing an increase in blood pressure.