If you meet requirements, you will sail through. Do you mind if I ask who your employer is? Just make sure that your submitted BMI is clearly documented as 40 and you have plain documentation to show the other dates, and you are good to go!

I have United with the same requirements and didn't quite meet requirements (BMI of 38.3 + comorbids on first submission); they didn't care that I had worked with my doc on physician supervised weight loss on and off since 2008. They didn't care that I could show BMI of 40 when I wasn't working with my doc. I fought thru two denials, and hired Walter Lindstrom's office. They handled the final appeal, which went to hubby's employer (ING). It was a one shot deal- if I won, I won, and if I didn't, I was done. Well, I won the appeal. The bigger news is that ING's medical director decided on the basis of Lindstrom's arguments that their policy was outdated and ordered United to change it to reflect prevailing medical thought.

I tell you this because if you are through ING, you should have looser restrictions and I would be curious to know if that is not the case. If not through ING, know that if something goes wrong, you do have another case that has been successfully argued and overturned against those requirements.

From what you say, you should be fine, but I wanted to give you some additional details should you need them good luck!

I have exhausted every possible route to try to get funding for my gastric sleeve. Such a horrible defeat!!! I just wish there was a way. My insurance has a exclusion. I cannot get financing. If anyone has any suggestions I would love to hear them!! 

 

The insurance coordinator at my surgeon's office recommended Horizon BCBS NJ as the easiest to get approved for surgery with.  I want the sleeve, but the problem is I can't get the company to tell me if they cover the sleeve without buying a policy first. I really don't want to waste thousands of dollars for a plan for a few months just for them to tell me the sleeve isn't a covered surgery. 

Does anyone have any experience with this? It says that bariatric surgery is covered under several of their individual self-pay plans, but it doesn't tell me if there are exclusions to that.

Thanks!

 

You are extremely lucky!  Did you get this in writing??

Probably not.  Ins co's don't want to cover obese people, PCIP has already taxed up billions and billions of dollars and while they have not fully implemented the program, they are already turning people away.  26 states will excude WLS.

Finance companies are requiring a credit score of 650 or above.

I would suggest a part time job at Starbucks, they cover WLS for part time employees.