Upset

[dixierose1226 0]

Im going to be scheduling my surgery tomorrow! My insurance isn't going to pay. Sucks, but I've got to do this! Looking to have the surgery around Columbus Day.

[kwicken1070 0]

From what I know, your BMI is not high enough to warrant insurance paying for it. It would be considered more cosmetic than for long term health. The insurance companies have all of this data and studies and know when they can save money over the long haul if someone is over 40 BMI

The LapBand is not a miracle cure. You have to work hard with this wonderful tool to make it work.

Whatever you do don't try for the 40 BMI, go the other way!!!

Good luck.

[brraaainnss 0]

My insurance won't cover the surgery if your BMI is below 40 - period. I have co-morbidities and am at 37.8... so my insurance said no way... gain 30 lbs and sure!

Luckily, I have a wonderful surgeon and his staff ...who let me weigh with my purse... and a 25 lb weight. ;D

[MellieW 0]

Brraaainnss,

If it's true that they let you weigh with your purse and a weight, that's insurance fraud and you both can be prosecuted for knowingly committing it. You might not want to advertise that.

Personally, I don't know that I'd want a surgeon that has no problem with knowingly committing a crime.... but that's me.

[brraaainnss 0]

The surgeon himself doesn't know about it, eesh.

I've seen it mentioned on this forum more than once or a dozen times that people are allowed to help their BMI in one way or another.

[helgainaz 0]

Many insurance companies require that you have a BMI over 40 for 6 months to a year. And have the medical documentation to prove it.

Holding your purse or weighing with your shoes on is one thing but adding a 25 lb weight to your purse is insurance fraud. If your insurance company ever does an audit of your case (which they can since they are required to do random audits) they'll be quite surprised to see that you lost that excess 25 lbs and more immediately after the surgery. I would be very careful.

Unfortunately I have a BMI of 39 and have to pay out of my own pocket. But I'm not willing to get fatter and wait a whole miserable year to get my insurance to pay.