Question:
Anyone out there that is only overweight and high BMI?

I am 172lbs over weight with a BMI of 53.9. I have my consultation on May 30. Was wondering if there is anyone out there that is just overweight and high BMI that has gotten approved with out any other medical problems. I have BC/BS PPO Prefferred and it is Medical neccessary before they will pay. Just wondering if I have enough Medical evidence.    — mgrimplin (posted on May 20, 2003)

May 19, 2003
Hello, when I had my surgery I was 27 with a BMI of 57. I had absolutely no comorbities and yet my BCBS of Michigan paid for the whole surgery. I went to BTC in Ypsilanti but from what I hear they no longer take BCBS. I didn't have to have a detailed list of the diets I tried, they just asked me if I tried them or not. Very simple for me, Good luck in your search.
   — Angela A.

May 19, 2003
I was 165 pounds overweight w/bmi of 52. I had no big comorbs but the doc said that my irregular periods and joint pains were enough. Also had the same insurance as you and was approved w/in one week. I never got a letter though -- the docs office told me. By the way, I have lost 170 pounds total. Good luck and God bless!
   — Kimberly L.

May 20, 2003
hi i am 5'4 276 lbs now and i got approved just because of my bmi it was 47.3 so it can happen
   — jolie S.

May 20, 2003
I have a BMI of 52 and no co-morbidities other than an arthritic knee that's controlled with medication. I haven't received approval yet -- my insurance is Kaiser, and the process to approval for them takes at least 6 months. However, my nutritionist (who will be putting in the paperwork for approval) said that lack of co-morbidities is a good thing. A high BMI and no co-morbidities makes you an almost perfect candidate for surgery. Depending on your surgeon, you may be told to lose a bit of weight before surgery to make it easier, but you won't have any of the concerns those with serious co-morbidities have. See if you can't get a copy of the complete guidelines from BC/BS. I'm betting they say you only need co-morbidities if your BMI is under 40.
   — antiques55

May 20, 2003
My BMI was 54.4 and I had no other co morbids. I have a Blue Cross PPO and had no problems with insurance. As a matter of fact anybody with a BMI above 50 is considered super morbidly obese so you should be fine getting approval. I have a lot of information on the early parts of my profile regarding how the insurance stuff worked for me if you are interested in reading about it. Good luck to you as you journey toward surgery. Wendi Open RNY 9/19/02 down 123lbs
   — lovemonterey

May 20, 2003
I am 5'2" and before WLS 223lb BMI 40.8 Morbidly Obese. In getting my pre-op testing I found out I had sleep apnea. Most overweight people do. I had no other complications and was approved by UnitedHealthcare/CustomCare Network.
   — Wanda R.

May 20, 2003
It can happen. I am preop but was approved right away. I have no co-morbidities but have a BMI of 44. I am 5"11 and at 320. Good luck to you.
   — Jeannie4

May 20, 2003
I have BMI 53.1 and no co-mor. My understanding is that if you are over 50. BMI you do not need any co-mor. to get approved, they feel that the obesity is your greatest risk. I have United Healthcare, and was approved without a problem. Surgery tomorrow (5/21/03) - Good Luck - Jill
   — J G.

May 21, 2003
IT REALLY DEPENDS ON WHAT THE REQUIREMENTS OF YOUR INS CO ARE. MOST INS CO WILL APPROVE YOU WITH A BMI OVER 50 EVEN IF YOU DONT HAVE ANY OTHER PROBLEMS. ALTHOUGH YOU PROBABLY DO & ARE JUST TO USED TO THEM YOU DON'T REALISE IT. HIGH BLOOD PRESURE, JOINT PAIN, BACK PAID, SHORTNESS OF BREATH. ALL OF THESE ARE C/M. MY BMI IS 57 & I KNOW I GOT SO USED TO ALL THIS STUFF THAT I WAS SHOCKED WHEN I READ THE LETTER FROM MY PCP TO THE INS CO & SHE LISTED ALL THESE AS C/M PLUS OTHERS. GOOD LUCK!!
   — PATRICIA S.

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