In the process....

Hi. Does anyone else have Great West Healthcare? They sent my doctor a 10 page criteria. But, the first one says a BMI of over 40 and I am way over that. Then it says OR ALL the following must be met. My doctor thinks I need to do all the other stuff. I would like for her to go ahead and refer me first. Anyone else going through this?

Hi Elesha, I noticed on your profile you listed that OHSU was the hospital, if that is who you are going through and you've already attended their lecture then they will contact the insurance company for you and get all the details of exactly what you have to do. The insurance guru there is Robin Downing. Good luck! Mary

Hi Elesha, Generally the standard is a BMI in excess of 40 or can be lower if you have 2 or more co-morbidities present like Diabetes, Sleep Apnea, Hypertension, etc. OHSU will submit paperwork on your behalf, not your PCP. Your Dr. just needs to do a referral. Sounds like she is hesitant to do that and it may be because she is not as aware of the gastric bypass procedure. Just ask her for the referral and let OHSU handle the rest. Pat