Question:
Has anyone been denied/approved for WLS with only MILD sleep apnea?

I have been denied during an appeal because I only have mild sleep apnea, AHI of 8. My CPAP setting is 12. I have several other comorbidities. What did you do? Have another sleep study?    — ERICK B. (posted on November 27, 2001)


November 27, 2001
Yes, indeed. I was covered by Harvard Pilgrim and while I had a bmi of 58, I didn't have many physical problems. I slept with three fat pillows under my head to keep me from waking up gagging in the middle of the night; so, my surgeon played up the sleep apnea. I probably had a very mild case of it. I had some knee pain. But that was it and my insurer approved me in a week.
   — [Anonymous]

November 27, 2001
My C-PAP setting was only 7 and I got approved! Just keep bugging them! Good Luck!
   — spatricknm

November 27, 2001
the mere fact that you need a CPAP machine for Sleep Apnea should be reason enough. no matter what you are rated at it is still a Comorbidity.
   — sbinkerd1

November 28, 2001
I was approved with the same diagnosis - "Mild Sleep Apnea". I never even got a C-PAP. My other co-morbidities were heel spurs, depression, rising blood pressure (not yet treated as hypertension, but probably should have been), and severe mentstral bleeding. I think what made the biggest difference for my insurer was the letter I wrote documenting every diet I had tried over 30 years, including the weight lost each time, and the time it took to gain it back. I was able to remember 70 (!) different diets - all taken quite seriously. I included scanned pictures of every phase of my wight yo-yos and ended the letter with "PLEASE HELP ME - I DON'T WANT TO LIVE LIKE THIS ANYMORE". I was approved in one day. Blue Cross / Blue Shield PPO. Good luck. Let me know if you'd like a copy of my letter.
   — Elizabeth G.




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