Estella 11 Posted March 10, 2011 My current BMI is slightly lower than the required 40 - it's about 39.9. I have no significant weight-related diseases, apparently PCOS doesn't count. The hospital's dietician says that I have to lose some weight prior to the operation to show them I can, or something like that. She also assured me that the surgeon won't deny me just because I lose weight, on the contrary, and that I will still be qualified for the operation. The problem is she doesn't cut the cheque, if you know what I mean. I suspect that she can make those promises because she doesn't decide on funding. My fear is that if I lose the tiniest bit of weight the universal health care in my country (Israel) won't agree to pay for the surgery. Suppose I lose 10 lbs, then the insurance denies me - I will regain that weight eventually anyway as I did in all past attempts. I will get screwed twice - no operation, same large number on the scale. Should I take her advice or disregard it? Share this post Link to post Share on other sites
kelli 3 Posted March 10, 2011 what insurance do you have? My sister just got denied with Aetna, she also had a BMI of slightly lower than 40 and she had high blood pressure and is taking meds for it, I went on a 6 month supervised diet and lost a little then gained it back, basically I am the same wieght now that I was when I started. I was worried too about the Insurance thinking I could loose it on my own,, but If I could do that I would not be taking drastic measures to loose it right? I heard that they just want to make sure you can stick to a plan, of excercise and healthy eating. So I basically told my PCP that I was increasing my excercise and watching what I ate. I have Cigna for the record.. Share this post Link to post Share on other sites
Estella 11 Posted March 10, 2011 what insurance do you have? My sister just got denied with Aetna, she also had a BMI of slightly lower than 40 and she had high blood pressure and is taking meds for it, I went on a 6 month supervised diet and lost a little then gained it back, basically I am the same wieght now that I was when I started. I was worried too about the Insurance thinking I could loose it on my own,, but If I could do that I would not be taking drastic measures to loose it right? I heard that they just want to make sure you can stick to a plan, of excercise and healthy eating. So I basically told my PCP that I was increasing my excercise and watching what I ate. I have Cigna for the record.. I don't live in the States. I'm from Israel, in which everyone is entitled to universal health care. The universal plan includes bariatric surgeries, as long as your BMI is 40 or higher or 35 with related diseases. Most people add private health care on top of the public one, especially now that the government has drained a lot of budgets from the public health system. I only have universal health care. All I know about the American health system I learned from a Michael Moore movie, quite shocking to be honest. How do you people live like that? If they want to see I can stick to a plan, well, I cannot. Perhaps for 3-4 months, then hunger takes over. I fear that any WL attempt outside of a surgery would only 1. stall/prevent me from getting the operation. 2. will end up like all the others = regaining every pound I lost. Share this post Link to post Share on other sites
t-salt 1 Posted March 10, 2011 Do you have sleep apnea? Sometimes this can be caused from being over weight and considered a related problem. I don't want to get political but Michael Moore is an idiot and a spin doctor. Share this post Link to post Share on other sites
Was a humpty dumpty 35 Posted March 12, 2011 I would just gain a little weight, they wan't to that magic number 40 bmi. Also make sure you get you height recheched. I found out today I am only 4' 11 not 5' 1 like my chart said. Share this post Link to post Share on other sites
AutumnLily 77 Posted March 12, 2011 Losing some weight pre-surgery is to shrink the liver to make the operation easier. I would contact your health care provider and ask about the coverage. Share this post Link to post Share on other sites
SkinnyGenes 0 Posted March 12, 2011 I'm not sure if this would apply to your situation, but this is what my docotor told me. You just need to weight in at a BMI of 40 or greater. That is the number they will submit to the insurance company. In your situation, I guess they would submit to a case manager for the universal system. He said that is the only number they submit. If i were in your shoes, I might treat myself to chocolate every night for a week and go back to be weighed. During the months of supervision, say you ate properly and excrised but remain status quo. I'm not a fan of lying but insurance is a b****. They will get over every way they can try. I cavet all this with, we need to learn a new way of eating and living. Pay attention in the nutrition classes (I have found them very infomation) and get it some thought about how you will living your new life. Share this post Link to post Share on other sites
Crabadams72 20 Posted March 12, 2011 My current BMI is slightly lower than the required 40 - it's about 39.9. I have no significant weight-related diseases, apparently PCOS doesn't count. The hospital's dietician says that I have to lose some weight prior to the operation to show them I can, or something like that. She also assured me that the surgeon won't deny me just because I lose weight, on the contrary, and that I will still be qualified for the operation. The problem is she doesn't cut the cheque, if you know what I mean. I suspect that she can make those promises because she doesn't decide on funding. My fear is that if I lose the tiniest bit of weight the universal health care in my country (Israel) won't agree to pay for the surgery. Suppose I lose 10 lbs, then the insurance denies me - I will regain that weight eventually anyway as I did in all past attempts. I will get screwed twice - no operation, same large number on the scale. Should I take her advice or disregard it? Well this is what some people do: don't shoot the messenger ok! Lose weight--say no more than 10-15 pounds for example. When you go in to the dr make sure you have your body weighted down, ankle weights, sweatpants, weight belt, weighted vest if you have to. I hate to think in this direction but they want you to get discouraged and not have the surgery. Share this post Link to post Share on other sites