Insurance HMO Problems for Lightweights BMI 38, etc.

SW
on 7/24/03 2:14 am - Laguna Beach, Ca
Hi my name is Susan DeMendoza and I've been trying to get approved for 4 months, when I first started out my BMI wasn't 40, but I thought i had plenty of co-morbs so it wouldn't make a difference, Boy was I wrong!! Don't even attempt to get approved until your weight and BMI are up to 40! I did have too gain alittle wt to make my BMI 38 go to 41.4, and get tested for Sleep Apnea, which I have, that I didn't even know, mild sleep apnea results, (I was so glad) Sleep Apnea and Diabetes, are the big co-morbs needed to get approved, also GERD. Well here it is 4 months later and I was getting ready to send in and Appeal to BC HMO, and my PCP wanted to weigh me again. I had written a letter in her behalf to attach to my appeal. Instead of signing it she wanted to weigh me again, and she stated that if my if my weight and BMI 40 she would send in another referral to see a bariatic surgeon! I never even had to send in my appeal! Today I will find out if the referral has been approved to see the surgeon! I am very excited, and the way she talked yesterday, she said to me it takes about 48 hrs. to get the approval, she was so positive that it would be approved. All I can tell you, those who are fighting with an HMO, is meet as many of their requirements as possible, Especially the BMI 40 and above!!!!! I had the co-morbs of family history morbid obesity, high blood pressure, very high cholestrol, asthma, etc. and they denied my because of my bmi not 40, only 38, so don't be denied like me with my first attempt, gain alittle weight, I know it is against all that we want to achieve (to be thin) but it is worth it, and it wasn't very hard to eat all the things I wanted and always felt guilty about! LOL! Good luck to all you lightweights like me! thats what they call us that are on the lighter side of BMI's/weight. God Bless! Hang in there, it will happen with perserverence and prayer. e-mail [email protected]
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