Question:
What do I do now? I was turned down for BMI under 40.

Stuck between a rock and a hard place!!! I am in need of some advice. My insurance BCBS denied me today saying that my BMI is under 40. My BMI is 38. I understand why they denied me, so I am not in total shock, but what to do now? I am 29 and been on diets since I was 14. I know that they dont work in the long run for me. Probably if I just did nothing and waited around for six months, I would gain weight anyway, and qualify. I hate to think of having to put on 10 lbs. just to qualify for surgery, but I am at a loss. Traditional weight loss methods may take 30 lbs off, but it wont take off the other 60 lbs off that I need to lose. Any advice???    — Tara J. (posted on September 6, 2001)

September 6, 2001
Hey there, try writing your insurance company a letter and including photographs. In the letter, explain what your daily life is like because of your weight.....tell them anything and everything, do not hold back! It is important that you include the photographs as well. Try taking pictures of you standing in a bathing suit or something revealing like that. I understand how frustrating this can be because I was denied twice before receiving insurance approval. I wrote a letter to my insurance company and included photographs and BEGGED for my life back.....I also emphasized how hard my day to day life was because I was so overweight.......being denied the first time isn't all that unusual, but fighting with appeals may be your only option. It eventually worked for me.....I had my surgery, am 4 months post-op and now down 130 lbs.......also, I only ended up paying $100 out of pocket to have the surgery.....Hang in there, keep your chin held high and DONT GIVE UP!!!!! They WANT you to give up, so they dont have to cover it......THAT ISNT AN OPTION! To hell with them, stay focused, girl.....and the very best of luck!
   — Heather W.

September 6, 2001
I did not notice that you mentioned any comorbidities. Some insurance companies will approve the procedure if your BMI is only over 35 so long as you can prove that you have other disorders or ailments in direct relationship to your obesity.
   — maresident

September 7, 2001
Tara- I went ahead and gained 15 pounds to qualify, and I have absolutely no regrets or guilt about it. 59 pounds down!
   — blank first name B.

January 15, 2003
I hope you have heard something since yor post. I just had my 1st visit with my Dr. and my BMI is 38.6 (100 lbs overweight). I do have mild sleep apnea which the Dc is including in my report to the insurance company, but I have this gut wrenching feeling they are going to deny me. I have fought a weight issue for many years especially after having 3 children and at 38 it is getting very hard to get the weight off. I want so bad to have this surgery and to think it is in the hands of complete strangers who do not walk in my shoes every day kinda of irratates me. Another thing that bugs me do you have people in your life that are desperately talking you out of this surgery - what's up with this? None of my offenders have any real good reasons for me not having the operation execpt maybe lack of information. I think my husband is a little jealous I might look too good (hee hee!!).
   — Carol H.

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