Question:
What insurance companies will cover this with a BMI of 36 and what type of co-morbids
Hello again, I'd really like anyone who got this operation with a BMI of 36 to let me know what co-morbids you had/have and most importantly, please let me know what insurance company approved you. I am more than willing to get another. Are HMOs or PPOs more likely to approve? I've sent e-mail to to health brokers, no response! Obesitylaw.com can not provide insurance information, Dr.Marema's office in Ft. Lauderdale by law, can not give out insurance advise. OSSG.com does not have an insurance database. I've asked about comparing insurance criteria here before and on OSSG. I'm sure someone has found a way of comparing the insurance companies critera and found which ones are flexible. My insurance company BCBS PPO refused to tell me the criteria they use!! All I know is that NURSES on some medical review board somewhere have the authority to override my physician!!! Please help me, The OSSG site referred me to you, people here have referred me to Obesitylaw.com and OSSG. If I had the money, I would pay for this myself, such a run a round by ins. companies. Katherine :) — Katherine N. (posted on March 9, 2000)
March 9, 2000
I don't recall my exact BMI. I was considered 96 pounds over my ideal when
approval was given. I am 5'5 and weighed around 235 when I received the
approval. i am insured by Prudential HMO. I am diabetic, however was not
on insulin except during pregnancy. I was said to have sleep apnea,
however I did not know it. I had pain in my joints and back pain and
horrific carpal tunnel in my left wrist from lack of circulation, I had to
sleep with a cock up splint. I also was experiencing urinary incontinance
and frequent diarreah. These are just some of my problems to name a few.
I am now 30 and was 29 at the time of surgery. I know that they were
concerned with my possible need for long term diabetic treatment due to my
history and family history. My grandmother died from related
complications.
— kelly P.
March 9, 2000
Katherine:
What makes you think that your BCBS will not approve you? I was approved
by my state BCBS in only one week. Yes, nurses make the decisions, but they
approved mine. They require that you be at least 100 pounds overweight.
Check out my new website and click on ND BCBS to see the other
requirements. Who knows, you may be doing all this checking out of other
insurance companies in vain. P.S. Remember, my website in brand new and
under construction, so some links don't work yet.
http://www.geocities.com/mrsverlin/index.html
— Cindy H.
March 9, 2000
My insurance company - Aetna PPO has approved two 37 BMI's I know of -
myself one of them. My co-morbids were high cholesterol, GERD, and
multiple sclerosis. My surgeon wrote that I was 94 lbs. overweight from my
ideal weight of 127. Hope this helps -
— Shar /.
March 9, 2000
I have a BMI of 36. I am around 70# overweight at this time. I have
several co-morbidities. My weight didn't seem to be an issue with the
surgeon. My health did. That is what the surgery is all about anyway.
Not being skinny, but being healthy. Good Luck and God Bless.
Kay LaCrosse
— CohenHeart
March 9, 2000
I have BCBS also. I have a BMI of 47 but I was told that if my doctor said
anything was medicalloy necessary, then my policy would cover. You need to
check your plans exceptions list to see if obesity treatments are excluded.
I changed companies based on that clause. Hope this helps. By the way
BCBS responded within 3 days.
— Tamilyn12
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