what qualifies as a comorbity ??

tanya8071
on 8/7/11 9:53 am
just trying to be clear on what exactly a comorbity is ?? not sure if it means something that means you can die from if you do or do not have a WLS ???
KarenCee
on 8/7/11 10:01 am - GA
I'm not sure if this depends on what your insurance company defines as comorbidities or if it is what the doctor defines as such.  My insurance company was pretty plain on what they considered comorbidities for this surgery:  diabetes (uncontrolled), high blood pressure, asthma were some of the ones that qualified me in addition to my BMI.  As a definition a comorbidity is two or more diseases or medical conditions that are in addition to an already diagnoses medical condition.  My insurance company uses this to determine eligibility for WLS.
Teaching is the essential profession, the one that makes all professions possible.  —David Haselkorn
  
      
MacMadame
on 8/7/11 10:48 am - Northern, CA
Te*****ally a co-morbidity is any disease or condition that is either a result of your obesity or made much worse by it. So, it's something that losing weight will cure or make much better.

Different insurance companies count different co-morbidities when they determine eligibility for WLS. They all count Type II Diabetes and Sleep Apnea. But the rest are a mixed bag.

For example, my insurance company only counts high blood pressure and high cholesterol if they are not well-controlled by medicine. They don't count things like asthma or arthritis at all. Some insurances want two co-morbidities if your BMI is under 40. But, even if you only have one, it's still a co-morbidity because that's a medical term, not an insurance term.

If your BMI is 40 or more, it's not important for insurance purposes because you qualify automatically.

(Note: we're talking about the US here.)

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Eliza55
on 8/8/11 6:03 am - PA
Hi Tanya
Call your insurance company (customer service on your card), and they will send you their policy.  My company limits it to three:  Coronary Heart Disease, Sleep Apnea, and Diabetes.  Each of these has significant impact on your health if not treated, and are long-term diseases.
Eliza
Consult:239   SW:217  1mo:195  2mo:182  3mo:169   6mo:139  9mo GOAL CW: +2 from underweight
  
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