Question:
Will my mother qualify if she is not 100lbs overweight?
My mother is 5'3 and 215lbs so she is not 100lbs overweight close but she does have medical problems, like high blood pressure, diabetes, high cholestrol, graves disease and thyroid problem, would she qualify for surgery because of the medical problems? — meredith B. (posted on April 19, 2002)
April 19, 2002
most insurance companies require a bmi of 35 to qualify with
comorbidities===call your insurance company and see what they require
— Linda L.
April 19, 2002
Hi- I am an "expert" at this question since I am about the same
size at 5'4" 210 lbs. And the answer is.... It all depends on the
insurance company and what their requirements are. There is a big
misconception out about having a BMI between 35-40 and co-morbidities.
Co-morbidities in themselves many times are not enough as in my case. My
insurance company Blue Cross of California covers "severe"
"uncontrolled" co-morbidities. The first thing you need to do is
request a copy of your mother's insurance company policy on bariatric
surgery. The policy should spell out what their standards for covering
surgery. In my case, last week my insurance company requested more
information from my physician on how my co-morbidities were life
threatening. After writing a six page letter with lots
of my own history and studies of my own co-morbidities I was approved the
next day. My surgery date was just schedule this week for June 6th. I have
several of the same co-morbidities as your mother. If my letter would be of
help to you, just email me and I will send you a copy.
— Joanie J.
April 19, 2002
I was "borderline" with a bmi of 40.7 and my insurance approved
me within 5 hours of receiving the material from my surgeon. My ins. had
paid for the diabetic testing supplies through 2 pregnancies, the x-rays
and physical therapy on bad knees, the sleep apnea testing---I think they
figured if I got the surgery I would stop costing them so much money
LOL...I have HealthNet Northeast (formerly PHS). By the way...I'm costing
them more $$$ this upcoming week by getting my gall bladder removed 23
weeks post op...I'm not done with them yet ::maniacal laugh:: LOL
Good luck
— Mustang
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