Question:
Are my co-morbidities enough to qualify me, GERD, anxiety, arthritus.
I'm hoping to have all my ducks in a row before the send it to the ins. co. I have other problems but I don't have them listed from my pcp. Please help, and my ins. is b/c b/s of tx ppo — blank first name B. (posted on March 12, 2004)
March 12, 2004
I have BCBS/PPO MI and was approved with no problem. I had sleep apnea,
arthritis, on&off high blood pressure, shortness of breath and many
failed diet plans. I'm left now post-op with arthritis. So mine were very
simple compared to those who have severe medical conditions, which makes me
so mad when they are denied. Good luck!
— Sandy M.
March 13, 2004
I don't have your insurance, but I don't have ANY co-morbidities and my
insurance approved me (State of Nevada Public Employee's Benefit Program).
In my letter that I wrote to the insurance company, I flat out said that I
am 23 years old and I don't have any co-morbidities. However, I have a
family history of obesity and I want to avoid co-morbidities and I'm headed
straight down that road. I just explained in detail about me, my family
history of obesity, and what being overweight does to me (shortness of
breath, aching joints and back, etc, etc,). I have my letter if you are
interested in seeing it to help you write your own. Just email me at
[email protected] and I'll email it back to you - anything to
help. I am happy to say that my surgery is on Wednesday 3/17! Good luck!
— Julie Rich
March 23, 2004
Look at the 12th question below yours here on Q&A - "letter I can
use as guideline". I wrote info there that will be helpful to you.
— bufordslipstick
March 23, 2004
It's all a matter of what your insurance requires. Some insurances will
approve with a BMI over 40 and no co-morbidities and BMI between 35-40 with
co-morbidities.
If your insurance requires co-morbidities, I'm not sure what would qualify
since co-morbidities are normally considered to be potentially life
threatening illnesses that will likely be corrected with weight loss.
Usually it's sleep apnea, diabetes, high blood pressure, etc. However,
your insurance may not require co-morbids in order to qualify.
I would get a copy of what's required for approval from them in writing so
if they change the requirements after you submit for approval (which they
can do), you can argue on the grounds that you met their requirements at
the time of your request.
Good Luck
— Carolyn M.
March 23, 2004
I have Fiserv Ins out of Nashville. And my surgery was approved due to
" hip joints hurting all the time" When I spoke to someone at my
Ins Co before surgery thats what they told me. No other reason where given.
And I had no problems. They approved it in about 3 weeks. Good luck
— Carrie W.
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