what if im not accepted?

January 11, 2006

hi this is my first time in here. im nervous and scared because i have a consultation on monday to see if i can have sugery for the band. what if im not accepted? then what?

ReneBean · January 11, 2006

Well - medically accepted, or accepted by your insurance company?

1st, your doc has to state that you are physically able to withstand the rigors of surgery.

2nd, your insurance company has to determine that the procedure is medically necessary - unless you happen to have 10-15 thousand dollars sitting around to pay with.

Why do you think you might not be accepted?

If you have a BMI of 40 or higher, and you have a history of obesity and attempts to correct the problem without surgery - you meet the basic criteria of most insurance companies.

Please let us know a little bit more about you, so we can advise properly.

And welcome to LBT!

:]

January 12, 2006

i meant accepted by the surgeon. but will have to wait till monday to find out. this is the last resort for me.

Alexandra · January 12, 2006

Tempest, it seems like you're anticipating the worst. Why would you not be "accepted" by the surgeon? They are only looking for good band candidates; it's not a personality contest or a lottery. If you're a good medical candidate for surgery, the doctor will take you on as a patient.

Why would you expect anything different? Do you think you might not be a good candidate, medically speaking?

January 12, 2006

its just that my bmi is 36 and ive been told that i may be refused. so thats why im worried. i need to lose 84lbs.

Alexandra · January 12, 2006

Ah. Well, with a BMI that low you are indeed going to have to come up with additional reasons why you need bariatric surgery. Do you also suffer from any of the common co-morbidities, such as diabetes, high blood pressure, sleep apnea, or bone/joint pain? Your weight must be having a negative effect on your health, so play up all the problems it's causing you when you speak with the doctor.

Particularly if you're looking for insurance to cover the cost, it's crucial that you prove medical necessity for the procedure. Convince your doctor, and then let him try to convince the insurance carrier.

Good luck!!

jobelle · January 13, 2006

Hey tempest-I'm kinda where you're at with the BMI (35.1), but I am being treated for HBP, high cholesterol, GERD. As a Registered Dental Hygienist, I've also been under treatment for musculoskeletal disorders. So that factors into the weight issue also. That has qualified me on several of the pre-qualification forms with several sites for various surgeons. But I have not had a consult yet, I'm just hoping all the info I'm getting will hold up when I make the move to consult with the surgeon I plan to use.

January 13, 2006

i hope all goes well and i'll keep my fingers crossed!

January 13, 2006

ive had sleep apnea for ages and have tpe 2 diabetes. my cholestols also high. if that wasnt bad enough theres joint pain too. especially in my knees. im in scotland so i dont have an option but to pay for the surgery myself. the waiting list for the nhs is several yrs.