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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