Question:
is there a length of time to have co-morbid before insurance agrees to pay?

   — hartnell (posted on January 30, 2006)

January 30, 2006
somebody answer this so I can know too
   — newgirlsc

January 30, 2006
Every insurance co is different. I didn't have any major co morbidities (Diabetes, hypertension, etc) just joint pain and GERD. My BMI was 42 and that is what qualified me. There really is a huge variation so what is true for one is not for the other and I think part of it is how willing your surgeon is to go to bat for you because I think most of the people in my surgeons office are approved so I don't know if they have just figured what needs to be said to get approval? Good luck to you!
   — SteffieBear15

January 30, 2006
Every insurance company is different! Your best bet is to check with your insurance company by phone or go to their website and get the clinical guidelines for the surgery. That will let you iknow exactly what your insurance company requires.
   — Novashannon

January 31, 2006
Hi Tracy - I was ultimately turned down because I did not have a BMI over 35 consistently for 5 years. But the catch is you have to diet, so while I was on the diet roller coaster I lost and gained thus affecting my BMI... I gave up and went to Mexico in Oct for the surgery and am currently down to 153. ~Kim
   — kimmy

January 31, 2006
It really does depend on your insurance company. I have Blue Choice (BCBS of GA) and had no problems. My BMI has only been greater than 40 in the last two years...although I have had weight issues all my life. I agree with the person up above that said it has a lot to do with your doctors office. My doctors office has a special team that does nothing but file claims for the patients...they know exactly what the insurance company wants...right down to the wording. My PCP had written a clearance letter and they had him re-write it to say specific wording...and it worked. The insurance company had my request and approved it all within a week. Perhaps attend some support groups and see if anyone there has your same insurance...maybe they can give you some insight as to what your insurance company is looking for....
   — mmcphee1