Questions if anyone knows

[phillygirl8133]

So I called my health insurance today just to get a little more educated about what I need to do to get approved they said I have to be co morbid of a 50 BMi and then she says but if obesity is my problem I need 35 or higher BMi which didn't make sence with something wrong with me so it's like now I'm 110over wt my BMi is 43.5 am I co morbid ughh so my questions is if I don't get approved which it don't seem like it how much is the sleeve to get done here in the US I don't wanna go to Mexico now cause no docs will help me here

[ElleMarie]

I am tired right now so maybe I am confused with your post but for clarity do you have a comorbid condition or not? 110 and 43.5 is usually enough from what I can recall of the medical necessity, but perhaps it has changed or your particular insurance company is just stricter. Perhaps it would be best to call your insurance company yourself and ask what the criteria is for them.

[phillygirl8133]

No I don't have anything wrong I'm healthy from what blood works says

[grammargirl0309]

I'm confused too. Usually, it's 35 WITH co-morbidities or 50 withOUT. Self-pay for the sleeve in the U.S. can be upwards of 18k, although I think a few people found docs who'd do it for 10k? I'm not sure. Don't be so opposed to Mexico. I went with Dr. Kelly. It was 6k total with my flight, and it was a good experience; he is an amazing surgeon, and I've had GREAT results. Hubby wants to get it done now, and I'd only send him to Dr. Kelly.

[hopefulstar]

My insurance is bmi 35 w comorb or 40 without compensate. Haven't heard many pple say 50 bmi is the requirement, 40 seems more typical from all the threads I've read. Good luck.

[hopefulstar]

Sorry I meant comorb not compensate . Damn auto text lol

[Dana]

right, 35 if you have a co morbidity and being 40 or over is its own co morbidity so you dont need another. if I didnt have insurance i would have went to mexico!

[dreamydeb]

my bmi was 39 and my weight was 214. i also have high bp. my surgery is in about 4 hrs!my ins was fidelis and afterthe required tests were all done incl 3mos dieting i was approved right away. im at 189 today by my scale and i cannot weight!

[phillygirl8133]

wow i hope i get approved good luck today let me know how it goes

[phillygirl8133]

im just not going to stress anymore about this approval anymore well ima try real hard not too i really would be so lost without this website i tell ya its a great thing

[gemini_1984]

Is there a way you can email them or send a message through their website? I know my insurance company has a website, you have to create user info based off your policy info and then there's a message center you can send and receive messages through. I opted this route instead of calling because honestly some people have no clue how to do their job - at least this gives the person on the other end the time to really look into the matter (do research if necessary) and get back to you still within a reasonable amount of time. Plus this way you have proof and/or documentation of what you were advised.

Good Luck!

[saramac]

Just remember you are likely to get denied at least once so prepare to appeal the decision. I had to appeal mine twice and was finally approved. Good luck!

[Texas_Pearl]

My surgeons office is taking care of all the insurance and making sure I have everything I need to meet the requirements. Is your Dr. helping you with this?

[phillygirl8133]

Yea they seem like I'll get approved but with everything my ins company is saying I need something wrong with me or have a bmi of 50 or 35 do I'm confused lol so on Monday I have to get 5 more testing done n my 2nd at management done I'm going to make sure I' find out what's gong on then

[Snowflake1350]

My Ins. requires an additional issue ( if you will) if your BMI is not high enough, like: Diabetes / High Blood pressure / Sleep apena / and others. That is probably what they meant.
My BMI is 35.8 so I ordinarly would not qualify but I have sleep apena, so they will be covering it.

Your DR should be able to assist with you getting all you need to be able to quality.

Good Luck