Question:
Do I have to wait for comorbidities to get this surgery?

I am 5'4" and 250 lbs, my Dr. is not at all interested in seeing me consider this surgery for my condition. I thought that if your BMI was high enough it didn't matter about the comorbidities, but BC/BC Fed PPO said that you have to have them wand a sugically necessary letter from your PCP. I have neither. What should I do?    — Danine N. (posted on March 16, 2001)

March 15, 2001
I also have bcbs Federal and a bmi of 40.3. All I had to have was a history of medical supervised diets and a bmi of over 40. I am scheduled to have surgery April llth in Salt Lake City, Utah. I did fight with the ins company and found out that the only requirements to be met were above. I had to do a lot of research on this and wrote many letters but because of not haveing approval I felt I really needed to know what the requirements were. I believe the ins co is giving you a run around. If you want you can email me at [email protected] and I could give you more info. You do not need a letter. I never had one.
   — Kathleen G.

March 16, 2001
I am scheduled for surgery April 11. I too have bcbs Federal. There are only two requirements to meet. one is a bmi of 40 or more and the other one is documented diets by a physician. That is all that they require. I had a lot of people telling me different things also. I had to do a lot of research and get specifics to make sure I was covered. It is still a risk as they do not pre-authorize. I am prepared to fight if they do not cover it. Email me and I can explain more @ [email protected] I am having my surgery in Utah. BCBS from Utah is paying for it but they are not going by bcbs regency requirements. They are going by bcbs Fed requirements which are a lot less strict. I do not have any co-morbidities either.
   — Kathleen G.

March 16, 2001
I am scheduled for surgery April 11. I too have bcbs Federal. There are only two requirements to meet. one is a bmi of 40 or more and the other one is documented diets by a physician. That is all that they require. I had a lot of people telling me different things also. I had to do a lot of research and get specifics to make sure I was covered. It is still a risk as they do not pre-authorize. I am prepared to fight if they do not cover it. Email me and I can explain more @ [email protected] I am having my surgery in Utah. BCBS from Utah is paying for it but they are not going by bcbs regency requirements. They are going by bcbs Fed requirements which are a lot less strict. I do not have any co-morbidities either.
   — Kathleen G.