Insurance question - getting approved though below BMI criteria

Esther B.
on 6/16/11 8:26 am - Rainy & Cloudy, WA

I will be starting a new job in a couple of weeks (don't you love all that paperwork?).  I was sent a link to their benefits website and of course the first thing I did was look if they covered WLS.  They did, but the minimum requirement is a BMI of 40.  I come in at 38 and don't really feel like eating my way up to 40, however I do present with Diabetes (Type 2 with Insulin), high blood pressure, high cholesterol, and bad knees. 

My question is, has anyone else managed to get approved for WLS based on co-morbidites even though they did not meet the minimum BMI? 

(I don't plan on asking to do this until I've worked there for a bit, even though all benefits would be available immediately.  I'm just curious so I can start to prepare for when I do need to present my case.)

Thanks in advance for any responses.

 

MajorMom
on 6/16/11 8:35 am - VA
Many policies will cover with a BMI between 35 and 40 as long as you have a couple of comorbidities to support the need. Don't give up. And, get a sleep study done to see if you have sleep apnea and require a CPAP. Good luck!

--gina

5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
                                 ******GOAL*******

Starting BMI between 35 and 40ish? 
Join us on the
Lightweights Board!
DS on Aug 9, 2007 with Dr. Hazem Elariny

Band to DS
on 6/16/11 12:25 pm, edited 2/4/12 3:45 am
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

(deactivated member)
on 6/16/11 4:36 pm - San Jose, CA
In many cases, a BMI of 35-39 and ONE serious comorbidity such as T2D will do it.
butercup
on 6/17/11 9:12 am - Kennewick, WA
That's what mine is.  It's fairly standard.
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