Young People : Did you get approved

[Lynn B 0]

Most surgeons follow the NIH guidlines for surgery qualification:

Must have been obese for at least 5 years

Must have at least 100 lbs to lose

BMI of 35 or more with co-morbidities, or BMI above 40 no co-morbidities needed

Documented attempts at weight loss in the past 2 years

No physical or emotional limitations to prevent participation and understanding of follow up care and eating expectations.

From what I understand, if you are self pay some doctors give you more wiggle room but if you want the ins. to pay then you will need to qualify.

Good luck!

[Morsaille 4]

Unless your Ins. has a written exclusion, like mine did. Absolutely no coverage for obesity related services including supplements, counseling, and surgery. Actually they added the exclusion while I was waiting for my approval. Sucks doesn't it?

Group Health

I had a BMI of 52 with multiple co-morbidities and documented weight loss attempts.

Luck fighting the good fight.

[Bostongurl 0]

I was approved same day as the paperwork was submitted and I'm only 28, 264 day of consult, and have no comorbidities.

I am from Mass. and have a local provider, Harvard Pilgrim HMO, and they are really amazing, easy to deal with, quickly approved me, etc.

[ladysplenda 1]

Both my daughter and I got turned down twice. Do not give up.My insurance said they did not cover it either. GUESS WHAT were banded

[ricanlady 0]

I'm 25 years old. I have amerihealth HMO. I had a BMI of 42. And my insurance didn't give me no problems. Actually when I called them the lady said to call her back to see how it went she was thinking about it. They approved even for fills for life. Anyways my doctor only charge 100 dollars for fills. But hey i don't have to put that out of my pocket now. I work at the casinos here in NJ, I don't know if you can get that insurance where you at. But you can go to Amerihealth.com. they only thing I had to pay was for my co-payments for my doctor.

Have a nice day.

Mel

[shauntil6266 0]

I am 20, and I was banded on march 29. My BMI was 35

[Jammin & Losin 1]

Hi I'm 28 years old and had several comorbities before being banded that have since gone away!! I was aproved within about 3 months after submitting to my ins company!!! I have been very pleased with my band and feel that I will be less likely to cost my ins company even more with medical since I am now healthier than ever!!!

[jude0426 0]

I am 35 years old and have struggled just as much in the past 10 years with my extra 50 to 60 lbs as anyone who is or has struggled with an extra 100+! We are all different. You can be 40 over weight and have every comorbidity there is, but be 200 over and not have one, so that tells me there is no comparison. With this said, I did not qualify through my insurance to have this procedure done. So, I chose self pay and went to Mexico (reason, the best doctor for the job). My surgery was the 31st of March 06. The day I left for Mexico I was 217 by my scale at home. That put me at around 33 or 34 BMI. As of yesterday I was down to 198 on my home scale. I am not sure why so much, probably Water weight etc. Of course this will fluctuate. Anyway, I am so glad I got this done, even if I do have to make payments on a loan for the next year!! It is well worth it to me. I certainly didn't want to wait until I was 100+ over weight to do anything about it. I am too young to miss out on my kids life and not be the one out there playing frisby or soccer with my them!

[sunflower 0]

Gosh, I have already been banded with not much success only 15 in one year. Does anybody know if Pacific care will approve aftercare for the band? I guess the best one to ask is my doctor. Also any of you who have paid out of pocket I hear its tax deductable I'm going to try anyway. Banded in TJ 6/05

Dr. Huacuz

Only -15lbs and pist!

not mad at doctor just at myself!

6 fills

[lisanjason 0]

Blue cross/Blue shield excludes anything having to do with weight loss.I self paid.I went to Mexico and was banded by Dr Kuri,six weeks ago.I paid $9000.I do plan on fighting them (Blue cross) with all I've got,for them to pay for an abdominal plasty when I'm done.Even if I have to get a lawyer.I refuse to have to pay out of pocket for both.

[Beaglebragade1 0]

ladysplenda- I am also 18, if you dont mind me asking, what insurance company did you and your daughter use and what was your daughter Amanda's BMI and weight? I am at a BMI of 41 and weigh 264. I also have ankle, knee and hip joint pains.

[JGray 0]

I was banded at age 25 with a BMI of 41. I tried once with United Healthcare through the policy that I carried on myself through work and was denied. Then changed to insurance under husbands United Healthcare policy and was approved within a week. Had surgery 5 days after approval date. No Comorbidities.

[Nana~ 4]

I was 26hadno issues getting approved~ 28 now and work changed me to Aetna and they wont pay my aftercare so now my fills are 175.00

[mrlddst 0]

I have Cigna, I was approved, I'm 26 with a BMI of 44.

[Beaglebragade1 0]

I am still under my moms insurance because I live at home. We have Blue Cross Blue Shield HMO, I havent talked to them yet, Im still trying to switch to a doctor that is going to be a little more aggressive about getting my thyroid under control, I have had an increase in my dose every 3 months for almost 3 years, and my doctor just doesnt seem to be caring as much as I'd like her to. so I am still not sure where i stand with all that