Question:
With a BMI of 62 do you have to have any MAJOR Co-Morbids?

I have back pain, sleep problems, asthma, walking problems. BMI 61 200 lbs overweight. No Dr. documented weight loss attemps. This all comes from my word. My pcp agrees with me and wrote a letter to my surgeon. Do you think I can get denied??    — [Anonymous] (posted on December 17, 2001)

December 17, 2001
I had a BMI of close to 62, and had no major co-morbid. I'm not sure what kind of insurance you have (I have BCBS Community Blue PPO) but with my Doctors letter and a psych evaluation, they approved me. E-mail me if you have any questions! [email protected] Good Luck!
   — Chloe S.

December 17, 2001
I also only pretty much had my word for previous diet documentation. With weight, BMI, co-morbidities, and just my say so on the numerous diets I had tried I was approved on my first request. You definitely appear to qualify, go for it! Best of luck to you!
   — Donna S.

December 17, 2001
I had a bmi of 56 and except for some mild (self diagnosed) sleep apnea and some arthritis in my knee, I was approved in a week. I didn't have documented proof of weight loss attempts. I just wrote a couple of paragraphs summarizing my attempts to lose weight over a twenry year period. The letter from your pcp to the surgeon was only a referral to the surgeon. The surgeon will assess you and if he deems you to be a candidate for wls, he (his staff) will submit documentation and get the approval from your insurer. Each insurer has different guidelines. You have to take it one step at a time.
   — [Anonymous]

December 18, 2001
I had a BMI of 43 with no major comorbids. I also had no doctor documented weight loss attempts. I was approved in 2 weeks. It all depends on your insurance. I have United Healthcare.
   — ctyst

February 8, 2004
That will depend oh your ins. carrier... My BMI is 61.2 and United Healthcare-EPO's only criteria is a BMI of 40.1 or higher... but it sounds like you HAVE issues/comordities.. it's all about how your pcp documents it... whenever you go to your pcp with a problem (asthms, back pain, etc) ask him/her "Is this because I'm fat?".... if the pcp makes that connection in your medical records and in the referral/recommendation letter it is to your advantage. Call your insurance company, talk to someone in the Benefits dept (always write down a full name, date and time)and ask them if they cover the surgery, what types of bariatric surgery are covered,what criteria do you have to meet to be approved for WLS? is there a set process you have to follow to get WLS approved by them? Having the right information will be your best friend in getting appoved...
   — debby H.