What do I do now?

So has anyone qualified with no co morbidities? I had some bloodwork done and the test results said that I had high cholesterol which is one of the co morbids that I need to have to qualify for surgery. My case manager called to verify my test results and the nurse said that my cholesterol wasn't too high. The doctor told me that it was. So my case manager said, well it's just bordeline. My case manager says I can appeal. So now what can I do? I'm sooooooo frustrated but I can't give up. Any advice would be greatly appreciated. I hate that being over 300lbs for atleast 10 years isn't enough verification. Insurance sucks!!!!!!!! I have even gone and lost 10 pounds of the 17 my case manager required. Pizza sounds soooo tempting right now. I won't give in.....right? HELP!!!!

I qualifed for surgery without a co-morbidities..... but my insurance did not require it if my BMI was over 40... which it was.

Helen

You may need to stretch a bit to find some co-morbidities...  Do you have extremity swelling - you know, ankles, feet, etc.?  How about back pain?  Stress incontinence?  High blood pressure?  Heartburn or acid reflux?  Anything like that?  I didn't really have a lot of co-morbids, either, and did get approval from my insurance, which was Cigna at the time.  I know all the insurance companies have different criteria.  I would definitely submit an appeal - and talk with Dr. Oh's staff about coming up with more co-morbids - hopefully his insurance person can help you out there.  Wishing you all the best - it's worth the fight with the insurance company!!  :)

I looked on the list of co-morbids that my insurance had and voila! I started having some of the symptoms! Back pain, shortness of breath...etc.
Check with your surgeon and see if there's anything else that might qualify as a co-morbidity. I was 300+ pre-op, and usually such a high BMI alone should qualify you.
GOOD LUCK!

Thank you for the ideas and encouragement. Lord knows I need it right now. I do have joint pain, back pain and incontinence but of coarse none of it is documented. So back to the Dr's I go. I know that in the end I will qualify. It's just a matter of jumping through all of the hoops and having a lot of patience. I'm so glad that I have all of you on OH to turn to in times like these.

May I ask which Insurance company you're trying to get approved through?

It is Aetna PEBB. The other thing that I need to do is find a doctor who can help me with my appeal. My PCP is a good Dr, but I think that I would benefit better from a Dr who has done it before.