Newbie here I need help!

[\Mara/ 11]

Hi!

I dont have any appointment yet...I just make the process of registration to take the seminar.... I have a BMI of 34, and Diabetes Type II, I got and read the insurance guideline...check the copy paste below:

The patient must meet all of the following

clinical criteria that include but are not

limited to:



BMI >

40 and strongly desiring substantial

weight loss to improve quality

of life, or >

35 with high risk comorbidity/i

es (obstructive sleep apnea,

Pickwickian syndrome, obesity-related cardiomyopathy, diabetes mellitus

Type 2 poorly controlled on insulin, or

obesity-induced physical problems

interfering with lif

estyle (e.g. joint disease treat

able but for the obesity, or

body size problems precluding or severely

interfering with employment,

family function and ambulation)



Continued obesity despite previous efforts at nutritionally and medically

sound weight loss that have been tr

ied and failed for a minimum of 6

months as documented in medical records



Psychological assessment for readiness and likelihood of success

completed



Patient demonstrates motivation and willingness to make necessary

changes in eating and drinking habits



Patient has attended support group or

other forum to learn about surgery

from other patients



Assessment for medical problems that

would increase risk of surgery has

been completed and addressed



Patient is able to participate in

treatment and long-term follow-up.



There are no untreated metabolic cause

s for obesity, such as adrenal or

thyroid disorders .

[skikyd 165]

My nutrition program is from my insurance company( their requirement)

Been having a mix up with my regular doctor signing my up. Lahey told me to lose 25 lbs before surgery. I am down 17 so far. I check in with Lahey next in11 days.

[skikyd 165]

Call the insurance company and ask for their written policy. Get a copy (probably online) print and read it carefully. Call them with any questions to clarify their policy and make sure you know all the "parts/pieces" that you need to have (ie: primary care doctor referral letter' date=' certain medical tests like an echocardiogram, and others, 3 or 6 months of a nutrition class, and more) You can start working on those things and gathering all of that. Keep calling them and getting all of your questions answered so that when you are ready to go to your seminar, you will be more confident of your insurance coverage.

As for your BMI, are you worried that you may be too low by the time you start your appointments? They supposedly take the first weight that they take from you at the start. If this is your worry, you need to maintain your weight now until your first weigh in. Or are you worrying for other reasons.

I hope this helps![/quote']

Thank you . That sounds like good advise!

[skikyd 165]

BI is Beth Israel. I am happy to help anytime!

I'd love to hear what you find out! Please keep me posted!

Beth Israel? I knew her as a child. We hung out with Vernal Pool.

[\Mara/ 11]

My nutrition program is from my insurance company( their requirement)

Been having a mix up with my regular doctor signing my up. Lahey told me to lose 25 lbs before surgery. I am down 17 so far. I check in with Lahey next in11 days.

What is ur bmi?

[RebecaSparkles 247]

I know I'll get flamed for this but...

Ankle weights and baggy pants. Instant bmi increase if you get the adjustable ankle weights you can take out a pound at a time to make it look like you are losing until you no longer need the weights.

I work in the medical field and fight insurance for prosthesis so people can walk. They won't pay and say you've been in a wheel chair you dont need to walk it's not medically necessary.

Honestly, what is the difference between needing to lose 80 # and # 90 ? In lapband land if following the rules about an extra month? Without lapband it can take you a year.

Cheating big time but if insurance wants to play games....

[vacationgirl1 6]

So with a BMI of 34, that may be a problem with your insurance if they say you need a BMI of 35 or greater with co-morbidities.

Call and talk to someone to ASK the insurance agent this specific question. Get their name and a "record #" for your talk with them. Write it down and keep a journal of all talks with insurance.

If you need a BMI of 35.... seriously, it may be that you have to gain a few pounds to hit a BMI of 35. YES, TOTALLY ridiculous, but you've got to play the insurance game to get done what you need done!!

[\Mara/ 11]

Oh girls, I need to gain some pounds, unbelieveble.....and maybe ankle weights lol. Not a bad idea lol... I think if I use ankle weights I will be very nerveous if thw nurse of the dr notice them....They will check me??? Any experience with that? Sounds weird, but I need the band, Im sick and tired of try diets, pills and excercise and yo-yo life, and I fight with my sugar levels too for my diabetes.

[\Mara/ 11]

I know I'll get flamed for this but...

Ankle weights and baggy pants. Instant bmi increase if you get the adjustable ankle weights you can take out a pound at a time to make it look like you are losing until you no longer need the weights.

I work in the medical field and fight insurance for prosthesis so people can walk. They won't pay and say you've been in a wheel chair you dont need to walk it's not medically necessary.

Honestly' date=' what is the difference between needing to lose 80 # and # 90 ? In lapband land if following the rules about an extra month? Without lapband it can take you a year.

Cheating big time but if insurance wants to play games....

[/quote']

Whats mean baggy pants?

[\Mara/ 11]

So with a BMI of 34' date=' that may be a problem with your insurance if they say you need a BMI of 35 or greater with co-morbidities.

Call and talk to someone to ASK the insurance agent this specific question. Get their name and a "record #" for your talk with them. Write it down and keep a journal of all talks with insurance.

If you need a BMI of 35.... seriously, it may be that you have to gain a few pounds to hit a BMI of 35. YES, TOTALLY ridiculous, but you've got to play the insurance game to get done what you need done!![/quote']

Thank you for ur support, I appreciate

[vacationgirl1 6]

I think you should gain 5 lbs or close. Find out by entering your height and a few pounds higher on the BMI calculator. See how many pounds you will need exactly. It shouldn't be more than 5 or so. Have a party for yourself. It will only take a week or two! You know how easy that is to do!

Play the insurance game. Get what you need to get done for your health in the long run!

[vacationgirl1 6]

Hey, I just checked out your profile. You need only to gain 2-3 pounds!!! To have a BMI of 35.1 you need to weigh 192 and to have a BMI of 35.3, you need to weigh 193!!!! You can do this in a week or less! This is your answer!!!!!!!!!!!!!!!

Go for it! You need to do this for yourself!!!!!!!!!!!

[RebecaSparkles 247]

Baggy pants are pants that have a loose fit. Such as bell bottoms also known as flares. Or boot cut pants. They have excess fabric and are not form fitting below the knee.

My hubby also recommended kegel weights for just a few pounds

At my appointments they have me remove my jacket and purse but leave my shoes and other clothes on.

I fully believe I could wear ankle weights & manipulate the scale quite easily. I'd only be cheating myself but in the long run, for me gaining 10 lbs & being denied would be worse than cheating & finding myself 10# underweight bc "oops I lost too much. " I rarely read of people underweight on the band that are complaining about being under goal. Usually you see yay under goal not boo undergoal & too thin.

That's the beauty of the band. Still too big, work the band. Too thin? Work the band the other way in concert with your nut.

Tl dr ( too long didnt read) :

Ankle weights yes! Can hide w/ good wardrobe choices & perhaps some duck tape. They aren't gonna look under my roles!

[skikyd 165]

What is ur bmi?

It was 40+ when I started. It is now 39-40. Depending what height I enter. I am 5'. 9 1/2".

At 5-9 and 5-10 I get different bmi's

[\Mara/ 11]

You know what , my husband check how tall Im, and for my surprise (one dr told me Im 5,2 in Puerto Rico a years ago) and he said Im 5,3! Im very sad today.... I need to recheck my bmi, thats not good