Question:
Will my mother qualify if she is not 100lbs overweight?

My mother is 5'3 and 215lbs so she is not 100lbs overweight close but she does have medical problems, like high blood pressure, diabetes, high cholestrol, graves disease and thyroid problem, would she qualify for surgery because of the medical problems?    — meredith B. (posted on April 19, 2002)

April 19, 2002
most insurance companies require a bmi of 35 to qualify with comorbidities===call your insurance company and see what they require
   — Linda L.

April 19, 2002
Hi- I am an "expert" at this question since I am about the same size at 5'4" 210 lbs. And the answer is.... It all depends on the insurance company and what their requirements are. There is a big misconception out about having a BMI between 35-40 and co-morbidities. Co-morbidities in themselves many times are not enough as in my case. My insurance company Blue Cross of California covers "severe" "uncontrolled" co-morbidities. The first thing you need to do is request a copy of your mother's insurance company policy on bariatric surgery. The policy should spell out what their standards for covering surgery. In my case, last week my insurance company requested more information from my physician on how my co-morbidities were life threatening. After writing a six page letter with lots of my own history and studies of my own co-morbidities I was approved the next day. My surgery date was just schedule this week for June 6th. I have several of the same co-morbidities as your mother. If my letter would be of help to you, just email me and I will send you a copy.
   — Joanie J.

April 19, 2002
I was "borderline" with a bmi of 40.7 and my insurance approved me within 5 hours of receiving the material from my surgeon. My ins. had paid for the diabetic testing supplies through 2 pregnancies, the x-rays and physical therapy on bad knees, the sleep apnea testing---I think they figured if I got the surgery I would stop costing them so much money LOL...I have HealthNet Northeast (formerly PHS). By the way...I'm costing them more $$$ this upcoming week by getting my gall bladder removed 23 weeks post op...I'm not done with them yet ::maniacal laugh:: LOL Good luck
   — Mustang