Hmm... I need to find out myself. I don't know what is the answer to that question. I'll do some research and get back to you if I discover an decent answer. You should email the people at Medifast as they probably can answer it..
The nurse actually just e-mailed me back and told me that insulin resistance is not one of the things that qualifies even though my BMI does qualify. Did you have to have something else wrong along with having a high BMI to have the.
As well? I'm going to try and talk with my doctor to see if he could write a letter stating that it is medically necessary since he is the one that recommended the.
I think the guideline for my insurance was BMI 35+ and 2 co-morbidities. Or BMI 40+ without co-morbidities. My starting BMI was 50, so I didn't really have to prove co-morbidities, but I had.
Apnea, and body pain from so much weight. So not the typical, diabetes and high blood pressure etc, a lot of people have with obesity. Definately don't give up and work with your regular doctor to get the paperwork proving medical necessity. On top of those requirments, you may also have to have 6-12 months of supervised Medifast diet with a nutritionist. I had to lose 10% or at least 30 lbs before I could schedule.
There is a lot of pre-op work to do. Wish you the best!!..
The first person I talked to said that if my BMI was 40+ I did not have to have any co-morbities but if it was lower than 40 you had to have co-morbities. My BMI is 46 so I thought that I would be fine until I talked to someone else with the insurance today. Hopefully I'll find some way around it! Thanks for the encouragement!..
If your doctor is encouraging you to get the GBS I am sure he/she will write you a letter. My co-morbidities were BMI 51, pre-diabetes (used to be called borderline diabetes), and high blood pressure...
Sounds like all of your info is either second-hand or being offerred by peope who don't really know. I always encourage folks who are trying to get.
To contact their insurance company and request a hard copy of their WLS coverage. Once you have that, you work with whomever deals with insurance in the surgeon's office. SueWright is correct about the drs note. BTW insulin resistance is the same as pre-diabetes...
I am not much help, I was approved because of my.
Apena, good luck...
There are soooo many co morbidities out there. Maybe you have one that you just aren't including. Here's a bunch off the top of my head. Arthritis and joint pain, polycystic ovarian disease, depression, ^BP,.
Apnea, ^cholesterol, diabetes, Acid reflux or GERD, Obesity-related psychosocial stress, stress urinary incontinence-pee when ya laugh or sneeze, infertility, i'm sure there are plenty more.......
Good luck to ya,.
My BMI is slightly under 40 and I was approved based on severe.
Apnea. Have you been tested? If you snore, it's worth getting tested...
I talked to my case manager today and she said that my Insulin Resistance may not be considered a co-morbidity for the.
She's going to talk to the medical director and see what he says. This is very disappointing news.. Has anyone else been approved with insulin resistance?..
I did get the WLS coverage from my insurance provider and to be approved you must also have a comorbidity unlike most insurances when your BMI is above 40. I do have lymphedema which is one of the approved comorbidities but it must be severe and mine is not extremely bad. I'm going to see my primary care doctor Wednesday so if I could get her to agree to write a letter indicating that I need the.
Because of my lymphedema then maybe they will approve me. Fortunately in about a year I will be on my own insurance plan instead of my parents so I may have to wait until then if this doesn't work out...
And also the nurse with my insurance company said that even if my endocrinologist wrote a letter about the insulin resistance it is still not accepted as a comorbidity...
Good thinking about getting your own insurance in a year. I was on a PPO which would only pay 80% and very strict rules. I had to wait a year to change my insurance from a PPO to an HMO. It was worth the wait. I haven't paid a dime except for my usual $15.00 co pay per visit. Now that I am nearly 2 years out I may switch back to the PPO so I can get my lap/arm/leg excess skin cut off.
You are doing great already just by joining DS and asking questions...
I had insulin resistance too. I had a huge bmi though and I had diabetes and high blood pressure. My doctor said that insulin resistance leads to diabetes if not treated with meds and/or weight reduction so maybe he can write a letter stating that...
Well amelie, I would definately try and get the insurance to approve you now. It took me 3 years and 4 different insurances before I could find one that paid for the.
AT ALL! I had one that approved of the.
, but my company changed 6 months into my preop requirements. Then I went thru 2 that did not cover it at all....Finally, my boyfriend had domestic partner insurance that covered me. It did pay for the.
In December. If you have a plan that covers the.
At alll.......try what you can to get it approved. DON'T WAIT!.
I have been trying to get my first appointment for 6 months now with my insurance you have to have a bmi of over 40 without any comorbidities and I have that along with high blood pressure, diabetes, back problems. the list goes on. It takes time to get through to the insurance company. I have filled out 3 forms so far my doctor is filling out a form now and trying to prove I need the.
I have had one canceled appointment for a phyciatric review and am supposed to go again the 18 of Febuary. I don't know at this time if that one will be canceled or notAll this just to tell you keep on keeping on and be as polite as you can as you go. The doctor and you have to jump through hoops to get this done. Six months and counting since I have a doctor on board and 5 years to find someone to find the doctor that would go through what needs to be done to get me there. Good Luck...