Jump to content
×
Are you looking for the BariatricPal Store? Go now!

What are the odds?



Recommended Posts

I've been thinking a lot of having lap band for quite some time now. I only recently started taking the steps towards possibly making that happen.

Based on the below and your experience, think I'll be approved? Maybe?

I'm 208lbs. I'm 5'5". But, when I went in for my intial appointment my doc said I seemed more like 5'4', which would mean that I am only 3 pounds from the 100 pound mark. I'm on Tricare Standard (south region) and they require at least 100 pounts overweight with comorbidities. Only, I'm not sure if you need just one or more health issues.

My health issues are that I have slightly elevated blood pressure and pre-diabetic according to my PCP. He did not feel I needed meds. His suggestion was lose weight....I even asked for weight loss drugs and he said "no." That's when I started to consider lap band.

So, knowing my weight and only being 3 pounds with my health issues (if they are issues) think I have a shot?

Will I get weighed again to see if I meet the weight requirement or is the initial weigh in the deciding factor?

Any input is appreciated.

Share this post


Link to post
Share on other sites

You need to have a BMI of 35 or over with at least one comorbidity (if you're 5'4" your BMI is just over 35). You need to have been diagnosed with diabetes or high blood pressure in order for it to count as a co-morbidity... "almost" doesn't count. You also usually need your primary care doctor to tell your insurance company that you are a good candidate for the surgery. If it doesn't seem like your doctor would be willing to do that for you, then your choices are to gain a little more weight and find a new doctor, or to look into self payment.

Initial weight (the first time you have an appointment at the surgeon's office) is what counts to be approved, because many people are made to lose weight in order to be approved for the surgery.

Soooo. Do I think you presently have a shot at being approved by your insurance? No, not quite laugh.gif But you should call them and see, as every insurance company is different.

I've been thinking a lot of having lap band for quite some time now. I only recently started taking the steps towards possibly making that happen.

Based on the below and your experience, think I'll be approved? Maybe?

I'm 208lbs. I'm 5'5". But, when I went in for my intial appointment my doc said I seemed more like 5'4', which would mean that I am only 3 pounds from the 100 pound mark. I'm on Tricare Standard (south region) and they require at least 100 pounts overweight with comorbidities. Only, I'm not sure if you need just one or more health issues.

My health issues are that I have slightly elevated blood pressure and pre-diabetic according to my PCP. He did not feel I needed meds. His suggestion was lose weight....I even asked for weight loss drugs and he said "no." That's when I started to consider lap band.

So, knowing my weight and only being 3 pounds with my health issues (if they are issues) think I have a shot?

Will I get weighed again to see if I meet the weight requirement or is the initial weigh in the deciding factor?

Any input is appreciated.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

    • Jenopolis

      Had a sleeve in 2017, lost over 100 pounds. Had a DS surgery this year (2025) for more sustainable weight loss. 🤞
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      The 14th was my day. I am home and recovery is going pretty smooth. They even let me walk out of the hospital. Picture of me in recovery curtesy of my boyfriend lol. 

      · 3 replies
      1. DaisyChainOz

        Glad it went well!! Wishing you a speedy recovery and wonderful success!! 🤗

      2. buildabetteranna

        Thank you ❤️

      3. Selina333

        Neat you have a pic of this day! I was sooo happy to get my surgery. It was well worth it! And I'm not even near my goal. I had surgery Dec. 2!

    • Alisa_S

      Bought a treadmill and some 5 lb weights. Time to get off my butt and get moving!
      · 1 reply
      1. DaisyChainOz

        That's a great choice! 😊

    • DaisyChainOz

      Surgery done!  Really looking forward to the next chapter 🥳😁
      · 3 replies
      1. GreenTealael

        Congratulations!!🎉

      2. Bugzy46

        Congrats

      3. Alisa_S

        Fantastic! Best of luck to you & I hope you're healing nicely & not having much pain!🙏

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×