Question:
I am 90 pounds overweight and BMI of 36 what are my chances for approval

I have several commorbidites, hypertension, high cholesterol, reflux, removed gall bladder, joint pain, long history of antidepressent use. I have two different insurances so if approval is possible, I do not think I will have much out of pocket expense. Any ideas?    — Michele C. (posted on November 29, 2002)

November 29, 2002
Most insurance companies will not consider wls on someone who has a BMI of under 40, unless the yhave some comorbities! but some companies are just cheap and greedy! good luck to you! i am fighting with mine now with a bmi of 64 and with all the comorbidites there are!!!! they still said no to me!
   — janetc00

November 29, 2002
Call your insurance company and ask them. It will probably have to be medically necessary. From what I have read on the insurer section here many consider medically necessary to be a BMI over 40 or between 35 and 40 with comorbids which you apparently have. I would also suggest going to the insurer section here and looking up Pacific Care for Colorado. I briefly looked at there appears to be several entries. When I was starting the process I emailed a couple of the more recent entries and asked about their experience with the insurer. There are many variables to the process. I read as much as I could, picked the surgeon and then started the process. Best of Luck to you.
   — Pat B.

November 30, 2002
HI THERE....WELL, WHEN I FIRST STARTED MY JOURNEY MY BMI WAS BARELY A 35, BUT I HAVE A BAD ANKLE AND HAVE TO WALK WITH A CANE, SO I WANTED THIS SURGERY REALLY BAD AND WAS ABLE TO GET MY BMI UP TO A 37.7 WITHIN 6 MONTHS AND HAD NO PROBLEM DOING IT. MY INSURANCE COMPANY DENIED ME AY FIRST BUT WITH A 12 PAGE APPEAL LETTER THEY HAD ME APPROVED IN 2 WEEKS AND MY SURGERY IS SCHEDULED DECEMBER 10, 02. I GEUSS ITS ALL ABOUT THE EFFORT AND HOW YOU GO ABOUT YOUR WHOLE APPROVAL PROCESS. GOOD LUCK
   — Karen W.

November 30, 2002
I have Pacificare of AZ. I had a BMI of 36 with Comorbids..diabetes, sleep apnea, high BP, high cholesteral, and was approved with the first submission by my surgeons office. Good Luck.
   — Diane R.

December 1, 2002
Hate to say this out loud, I had to gain 8 pounds to meet the 40 mark. But I did it. I hate until I thought I wasn't going to be able to eat anymore. Went to the doctor and guess what, They measured me a tad shorter than what I had measured at my work. I wasn't going to argue with them. ; )
   — Sherry C.

December 1, 2002
Call your insurance company - you must meet their requirements for coverage. OR perhaps you are self pay? Then I guess you just need to find a surgeon.
   — Marianne K.