Question:
I am so confused on BMI requirements, too many rules HELP!!!!

I am a 27 yr old female who is 4ft11 (sometimes 5ft with shoes) I am at a little over the 35 BMI. I bounce between 35 and 36 depending on which table you use. I am also not sure of how much I should weigh. Right now I weight 185 lbs. I have a consultation on Aug 28. I have several Co-morbids and I know this will help. I have emailed 2 surgeons just to ask this same question. I received email back and they said they would never do the surgery. I guess they do not realize how hard it has been for me. This is my absolute last hope. Is there anyone else who is my size, and had the surgery done???    — Michelle P. (posted on August 8, 2000)


August 8, 2000
I just read your question. One night I stumbled upon the Humana web site. You need to go into the provider(your dr)side. Rather than the patient information. This side addresses concerns for prior authorization of which WLS needs. There for you to print out are all the requirements of both Gastroplasty and Abdominoplasty. Browse around in this site it is very enlightening...and unless you live in Ca or Co or have a contractural exclusion by the employer the policy of this insurance is quite liberal, I thought. I dug out my papers to see if I had the web site address but it is not printed on my printout. If you need help locating the site e-mail me and I will look around on the internet and find it. Your company should provide you with exact contract information on your insurance (exclusions) so you can know if you are covered. It is their obligation to spell out the exact language of your policy(or provide you a copy)either the Human Resources person or repeated calls to Humana(who is sometimes less than correct, friendly or helpful...I found regarding another issue) persistence is the key here.
   — JennyLynn A.




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