HazelEyez87

I'm going to my doctor this Wednesday to talk to him about my "options". I am still on my father's insurance. I'm curious....are there any basic "hang ups" that would keep insurance from covering the surgery? I was reading through some websites and they say you are a prospective client if not having the surgery is even more of a health risk. Both my parents are diabetic and have heart disease. My father has sleep apnea too. His parents both had high blood pressure and heart disease, dying of heart attacks. My mother's parents had cancer issues, heart disease and also high blood pressure. One dying of cancer and the other a heart attack, all under the age of 70. I just started getting high blood pressure problems, so it would be safe to say that I am looking at a rough future (just based on genetics) even if I wasn't overweight. Would there be any bumps in the road when it comes to insurance or does it vary depending on what company you have coverage under?

hexx2003

It really depends on your insurance as to what hurdles you must go through. But your co morbidities as well as family history can play a big part in the decision. You just need to have everything documented by your PCP especially any family history as to what you can expect if you stay overweight. Alot of insurance cos will approve at 35 BMI with substantial co morbidities! So I would look into your policy and see what they require and what the limitations are and then get your PCP on board with your decision. Start now, because regardless of your situation, your insurance co may require supervised diets or waiting time. So you need to start asap to get through that before you have any insurance issues.

__________________
Heather

Surgery date 01/13/2009
VA People.. JOIN VIRGINIA IS FOR LOSERS GROUP!!http://www.thinnertimesforum.com/gro...ia-losers.html

Highest Weight 346 lbs 55.5 BMI
Day of Surgery:342.5 lbs 55.5 BMI
Current: 208 lbs 33.6 BMI (omg.. finally below 40!)
1st Goal: 250 lbs (The weight on my id's!! LOL) CHECK!!!!!!
2nd Goal: 1-- I want to see a 1!!
Surgeons goal:150 lbs (appearently i am big boned

Down 135 lbs since 1/13!
Expecting our first Kid 6/19/2010 thanks to WLS!

njnicole10

first thing the lady at my surgeons office told us to do was call the health insurance company directly and ask if you have an exclusion for bariatric surgery. if they say no, then ask what exactly you need to do in order to get the surgery approved. your surgeons office should have an insurance coordinator that will walk you threw all the steps in getting your insurance to cover your surgery. if the insurance company says you have an exclusion in your health insurance coverage then u will not be approved regaurdless of what you do. best of luck!
*Nicole*
gastric bypass scheduled 12/29/08

Aviator

Insurance generally will not pay if your BMI is below 40. If you have a certain number of co-morbidities like high blood pressure, hyperlipidemia, osteo-arthrits in joints, the BMI requirement for insurance payment is generally 35.

My insurance company has a specific policy exclusion for Bariatric Surgery, so I have to pay cash. But that is variable employer to employer and dependent upon what is negotiated to set premiums.

Unfortunately there is no slam-dunk with insurance.

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Aviator aka AeroBear
Vertical Sleeve Gastrectomy
Surgery date: Dec 31, 2008
Post Op wt: 310
Current wt: 229.7
Goal wt: 210
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