Does PCOS play a part in getting insurance approval?

I just  found this forum.  I'm in the process of getting my requirements done for my insurance.  I'm wondering if PCOS will be one of the health factors that will be in my favor.  I've been on Metformin for 6 years (makes me terribly sick), I've spent thousands on Laser Hair Removal, I haven't had a menstrual cycle in about a year, I'm infertile and suffering from insulin rejection.   I'm assuming I won't have infertility issues after WLS, correct? Any comments would be great.  Thanks.

Hi, I know for me PCOS was listed as a co-morbidity, in the fact that it can lead to a lot of conditions. It may depend on how your insurance views it. As for the infertility, I've heard WLS helps, but there is no guarantee. You might want to visit the post-op pregnancy forum. The ladies have  alot of useful info, and a ttc group. Good Luck with your surgery.

Hey... hope I'm not being too nosey but who do you have insurance with??  I have United Healthcare and am wondering if PCOS is a co-morbidity. Crystal

Hi Crystal, no you aren't being nosey. I have Great West Healthcare. It's interesting, because I tried for approval with each insurance I  had. Each time I was denied. What I finally learned, is that it's not entirely the insurance company's requirements. If you have insurance through your workplace, it's the contract they write with the insurance. For example, the insurance co.and your work negotiate contracts, exceptions, exclusions like weight loss surgery etc.  and this determines your workplaces costs for insurance. I finally found  a place of employment that didn't have weight loss procedures excluded from the policy. So it was really my workplace that was the ultimate determining factor. But then you still have to jump through the hoops of all the insurance requirements before the surgery is approved. The key is to read your workplace's policy or wherever you have insurance through and see if it has weight loss exceptions and exclusions. If it mentions nothing you are probably in good shape, or in my case my policy said "weight loss procedures may be approved with co-morbid conditions". In my case, I had to work hand in hand with my doctors to prove I had co-morbid conditions. I hope I helped and wasn't confusing. If so, just write back. Good luck to you. I know it is all frustrating. Bridget

And for me PCOS wasn't a comorbid...but fortunately I had enough other problems that I didn't need it.  Call your insurance company and see if they can fax you a list of what they consider to be comorbid conditions. Good luck with your fertility afterwards too!  Like you I was very....VERY....infertile before surgery.  Once I was a year out I found out that I'd gone from no cycles...to 36 day cycles with ovulation!  Fortunately for us we were able to get pregnant our first month trying and now have a beautiful little girl!  Good luck! Kristy

I tried to use the PCOS for my surgery approval but they would not consider it.  Like someone else said it was not considered a comorbidity...but find out what your insurance company states... if it says you are 40 bmi, 100 lbs overweight, you should not need 3 comorbidities.  With BCBS, if you were a 35 bmi, you had to have 3 comorbidities.