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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]United Health care would not cover anything weight loss related. I am not diabetic. I am on Qsymia and I private pay.[/quote]

I don’t understand this.  A healthy weight prevents so many issues they’ll pay for down the road. I hope it changes. [/quote]

Agree.  I'm in primary care and have to deal (unsuccessfully, usually) with prior authorization and medical necessity.  _why_ BCBS, Aetna, etc. would push back against these prescriptions for long-time obese patients is truly beyond my understanding.

I mean, would BCBS rather pay for the looming type 2 diabetes that's right around the corner, guaranteed?  With its attendant chronic kidney disease, glaucoma and wounds?  Or how about the double knee replacements that are likely to come? Maybe Aetna and Cigna just really enjoy writing the checks for all the cancer treatments made necessary by obesity (colon, most breast, uterine, pancreatic).

It's really, really easy and straightforward to submit documentation that Jane Doe is obese and has one related chronic disease (even simple osteoarthritis). But the insurers fight even that!  A BMI of 35 is obese, full stop. Yet coverage is routinely denied on the first submission and sometimes on subsequent attempts.

They're shooting themselves in the feet, and I feel like there's a reason hiding in plain sight but I can't identify it.

[/quote]

I thought a BMI over 30 was obese. Over 35 is morbidly obese?[/quote]

Here is what the CDC says:
Adult Body Mass Index
BMI is a person’s weight in kilograms divided by the square of height in meters. A high BMI can indicate high body fatness.

To calculate BMI, see the Adult BMI Calculator or determine BMI by finding your height and weight in this BMI Index Chart.

If your BMI is less than 18.5, it falls within the underweight range.
If your BMI is 18.5 to <25, it falls within the healthy weight range.
If your BMI is 25.0 to <30, it falls within the overweight range.
If your BMI is 30.0 or higher, it falls within the obesity range.
Obesity is frequently subdivided into categories:

Class 1: BMI of 30 to < 35
Class 2: BMI of 35 to < 40
Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “severe” obesity.[/quote]

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