Question:
Is it possible for insurance co. to pick and choose co-morbids???

My ins. co. is PHP. They only accept the following for co-morbid conditions: diabetes,hypertention that is not controlled after using Rx, Genetically high cholesterol unable to be controlled by Rx and diet, CHF, and O2 level deficiencies proven by ABG test. Well, if ya have Sleep apnea, they don't care, asthma doesn't count, Gerd don't matter, joint pains are your problem.... Whats up w/ this??    — Nickie C. (posted on January 2, 2003)

January 2, 2003
mine had a list of acceptable co-morbids as well. You only had to have one, but it had to be one of the ones. They considered them to be the most life-threatening and/OR most costly to the insurance company in the long run (and I bet that's way more important than life-threatening in their books). Anyway, it may not seem fair but I wouldn't be surprised if they don't turn you down considering the co-morbids you list along with a BMI of 36. I'm not saying you don't need or deserve the surgery, but not many insurances are willing to pay the big bucks unless you are costing them big bucks in advance of the surgery or look like you are going to because your weight is so high (40 bmi or higher) and have multiple co-morbids. Good luck - I hope you get what you need!
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