I have started the process of getting the medical clearances for my surgeon's office to send to my insurance for approval. They gave me a packet of general guidelines such as 3 support group meetings, 3 nutrition visits, etc, but advised me to call my insurance company directly to make sure that there wasn't anything extra or different that they required.
So I called Amerihealth today (I live in NJ) and provided them the service code for the sleeve and the representative said that for the sleeve procedure I need to have a BMI of "greater than or equal to 50". That kinda seems excessive to me. The packet I have from my doctors office says: "Greater than 40 or 35 with co-morbidities". Now that being said, I may already meet the requirements (At the present time) if my height is listed at 5'3 then my BMI is 51, if its listed at 5'4 my BMI is 49.88. But I was planning to try to lose 10-20 pounds before my anticipated surgery date in September. That would put me below 50 for sure.
Does anyone else have any experience with Amerihealth or another insurance requiring this? Or does it sound like the rep is nuts?
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