Tuesday, November 3, 2009

Insurance requirements

So feeling kinda down. Hubby came through and talked to the insurance company about the band. They recently changed their requirements and we wanted to make sure it was still covered. It is but it's definitely changed and, at least for me, not for the better. I've compared the two below.

Old coverage:

BMI >40 alone or >38 w/two comorbidities

6 month supervised diet

New coverage

BMI >35 w/one comorbidity

6 month supervised diet

Okay...I know this doesn't sound too bad. It actually sounds better with the lower BMI right? Well, here's the BMI is 42.5 and, as far as I know, I have NO comorbidities. The reason I'm getting the stinkin' surgery is so I don't develop comorbidities. My father has Type II diabetes and heart disease. My grandfather died of complication with Type II Diabetes. There's history of several different kinds of cancers on my mom's side, breast and ovarian for sure but don't remember the others, but I recall reading somewhere that obesity can increase your odds of getting them. I don't want to deal with the diabetic nonsense which is why I wanted to do this. I'm still going to go see a surgeon and see if they can find a comorbidity to that insurance will cover it but I'm not as optimistic as I was. What I was really hoping for with the change of coverage was that they would do away with the 6 month diet. At six months, if I get in to see the doc in November, the earliest I could have the surgery is May/June, but realistically July. That's sooo far away.


The Dash! said...

Blahh that sucks having to have co-morbidities as well as a high BMI. Here in Australia we only had to have a bmi over 40 so I whispered in. Isn't being overweight a co-morbidity enough for them. Hope it works out for you :)

Anonymous said...

Let me guess, you must either have cigna or aetna health insurance. Hang in there, they will come through, (I had to come up with sleep apnea, which I had and didn't know it). My doctors were great in dealing with health insurance, WLIAZ, here in PHX. I had surgery March of 08, down over 100 lbs, best thing I ever did! Good luck to you!

MandaPanda said...

I have United Healthcare but aren't they all basically the same? Congratulations on your loss; truly amazing!

Cara - just finished reading through your blog. I've got to get to Australia one of these days...