Insurance Question...

[alley-gator 96]

So....I am at a 40.0 bmi right now exactly. My insurance pays for lap band at a 40.0, ir 35 with 2 co morbidities, and I only have 1. Okay fine, so I qualify because I am at 40.0 bmi great. But they also require a 6 month diet which I am just starting... There is no doubt I will lose at least 3 lbs, and drop below 40.0 bmi since I am barely there to start. This would mean I will not be eligible for surgery, correct? So why even start this process!

So frustrated. This happen to anyone else?

[justathing2me 146]

I had the same question when I started my 6 month supervised diet. My starting BMI was 40.9 and I am now at 37.4. My surgery is scheduled for August 1st but I have more than two comorbidities. I checked with my doctor's office who contacted the insurance to see what weight they go by. Mine goes by your end weight but some go by your first weigh in. I would check with your insurance or Drs office.

[Lela Clark 41]

I had to do the same 6 month plan for my insurance. My surgeons nurse told me to just not lose any weight. Dont change anything. I dont know everything you have to do to prepare for your surgeon, but by the time I got all my appts done (tests, nutritionist, evals) the six months are up. I do have to see a cardiologist because of EKG came back abnormal. I was really frustrated at first to. If I could lose the weight by dieting I wouldnt need the surgery. I think the insurance companies hope some people will change their minds since they will have to wait so long.

[Lollicatt 36]

I was at 40 too when I started and my doc advised me to not lose an ounce or I wouldn't be qualified. I know that's counterproductive for the 6month supervised diet but.. .it worked! I was approved at first submission.

[mufasas-mom 170]

call the insurance company - not your doctor's office - ask if they use the starting weight/bmi or the ending weight/bmi. I double checked this with my insurance and luckily they use the beginning weight/bmi. every time i go onto the true results office for weigh in and such - i've lost a few pounds - they just say - we'll put it at 197 to be safe.

don't take anyone's word for it at your dr's office - there are WAY too many insurance policies out there and tons of variations of each policy....double check it yourself!!

[Mayasgram 351]

My refering Dr said this is crazy .............don't you lose a pound as I was borderline BMI. I had to go for a year so 6 monthes sounds a lot better. It was hard to wait but worth it in the long run.. I spent lots of nights crying while I tried to be patient..