Question:
I have BCBS HMO/ Blue Advantage. I have a BMI of 46 with only a few co-morbidities.
I have my first date with my surgeon on 9/15/03 and i was wondering if i will have any problems getting approved. Anyone else in the same situation? Thanks — T P. (posted on August 28, 2003)
August 28, 2003
I had a BMI of 56 but had almost no co mormidities. I was pretty much a
healthy fat person (if there is such a thing). I had community blue and had
no problems for the gastric bypass. good luck...phyllis
— candymom64
August 28, 2003
I'm in the same situation ,my appt is sept 15 also and I have bcbc hmo. My
bmi is 54 with high blood pressure, depression and swollen ankles and
feet. I was told today by bc that they will not approve unless you have
serious medical conditions like gerd, diabetes and highblood pressure.
They are getting very strict now so i will be praying for us both
— shae7755
August 28, 2003
This likely only issue here is whether your policy covers WLS at all. If
it covers for MO then you qualify. You are not even close to being
borderline, which is a 40. So the fact that you also have a few co-morbs
should be an added bonus. I'd call and check on the policy first rather
than get your hopes up. If there is some special requirements or
exclusions better to know them when you see the doctor so they can tailor
their approval letter to address those things.
— zoedogcbr
August 28, 2003
I too have bcbs and was approved with a BMI of 40.My co morbidities
included borderline diabetes,severe joint and back pain,depression and
sleep apnea( Not sleeping well). I was afraid that wasnt enough but it was.
They requested a tsh(thyroid test) and wanted to know how many centimeters
would be removed during surgery.I wasnt required to have a 6 month
medically supervised diet but had previously seen diet specialist and tried
many differnet RX diet pills and I sent in those records.
— loisph
August 28, 2003
I hhad Blue Cross and Blue Shield of Michigan and I only had mild sleep
apnea (didn't need the c-pap), mild hypertension, fibromyalgia and was
diagnosed to be glucose intolerant. In other words I was on the road to
diabetes. Anyway, they had not problem approving me as long as the surgery
was recommended by my doctor, nothing else was causing my health issues at
the time (like thyroid, and I passed my psych exam. I don't expect you will
have any problems, you can always call the 800 number on your card to be
sure.
— Sandra Z.
August 28, 2003
I have community blue, and have my first consult on Sept. 17. I live in
Michigan, and the requirements are to have a BMI more than 50% over your
ideal BMI, and two co-morbidities. Even Blue Care Network has approved the
surgery for some.
— Vicki R.
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