Lap Band Insurance Denied

[alefig 0]

- I have 2 diabetes ...

- Hi Cholesterol..

I have been on several prescription medicines for the past 2 years and it just seems to get worst ..

I had mentioned this to my endocrinologyst .. but he was not ok with the surgery.

I went to my primary care physician she requested it under medical necessity and it was denied ...

because I did not meet the "criteria" ... what is the BMI that I must have in order for my insurance to cover this?

[gind 0]

For my insurance you have to be 2 to 3x your idea body weight. like I am 260 and my idea body weight is 112. I qualify. For the system you haev to have a BMI of at leat 40 if no issues and can be less if diabetic. I would appeal.

[Papillon Princess 13]

TYPICALLY BMI of 35+ with documented comordities or 40+ without. Make sure your insurance doesn't have a clause excluding WLS (some of them do) If your PCP did this, it may not have been approved due to the way she wrote it up. YOu may want to consider finding out why you were denied and visiting a bariatric surgeon for the letter of medical necessity. It sounds like you have not gone through the 3 or 6 month pre op diet (which is required by many ins companies)

- I have 2 diabetes ...

- Hi Cholesterol..

I have been on several prescription medicines for the past 2 years and it just seems to get worst ..

I had mentioned this to my endocrinologyst .. but he was not ok with the surgery.

I went to my primary care physician she requested it under medical necessity and it was denied ...

because I did not meet the "criteria" ... what is the BMI that I must have in order for my insurance to cover this?