medically necessary?

Hello everyone
Im new here and im looking to get gastric bypass. Ive gone to some information sessions at Beth Israel deaconess medical center. Ive also completed some mandatory appointments such as: blood test, abdominal/gallbladder ultrasound, sleep study, nutritionist and psychological visit. Next week I have my last set of appointments which consists of an EKG, meeting the nurse and last but not least the medical director.

Im beginning to get nervous about whether or not ill be approved. I don't have any Comorbidities like high blood pressure or diabetes, if anything I have an arthritic ankle. Im still waiting on my sleep study results to know if I have sleep apnea or not. I guess what im getting at is this: is having a high BMI considered medically necessary? I have a BMI of 51.3 and have network health forward for insurance. Ive called them and from what I gather my surgery has to be medically necessary to be approved.

Any thoughts or answers to my questions and concerns would be most appreciated. Thank you

Hi,

I believe the guidelines for weight loss surgery are  If you have a BMI over 40, or over 35 with co-morbidities.  So you should have no problem qualifying.

Best of luck with your weight loss journey.  It is an adventure, and I think you'll be so glad you did it.

Carol

Thank you so much

I was at a 40 bmi with no co morbidities and my insurance approved me. I had BcBs. It took 6 months from start to have surgery.

Oh that's great! Did your insurance have you meet any requirements?