Questions For You All

[LVikingFan 14]

Hi. My husband was sleeved back in July and has really learned a lot from you guys. Now I am considering surgery too. I have lost about 50 pounds just following the diet he eats, (but admittedly eating a little more). I am going to start my 6month diet as required by our insurance company this month. I am wondering, if I continue to lose weight on my own will they turn me down for the surgery? I am still diabetic and have high blood pressure. I need to lose about 100 more pounds to be healthy. I know that I can't continue eating just the little bits without some sort of help, like a sleeve.

[Mrs.Newme 21]

I wish I could give feedback to you on this. I had my own requirements by my insurance company. I met all of them, but one of their particulars was you had to be over a 40 BMI which I was. Plus a psych eval and the PCP approval. Good luck. It is nice that you have been able to see the effects of this personally at home with your spouse, and you have someone there who understands what you will be going through. My husband lost weight, but only because I am not cooking right now.

[MeMeMEEE 206]

My insurance specifies that the 40 BMI is at the beginning of the 6 months. To me that implies you are ok if you dip below during the 6 months.

[happy1957 138]

My insurance company require a 40 BMI for 24 months. Fortunately they use the very first weigh in at the nutritionist. I think your Dr would actually be pleased if you lost weight after that and before surgery. Your bariactric counselor would be the person to ask, get all the advice you can from them and bug the insurance company so that you meet their requirements as well. The best of luck

[CCWriter 19]

You might check out the insurance forums on here and see if there is one regarding your insurance company.

Because you have co-morbidities of diabetes and high blood pressure, your BMI requirement might be lower than if you didn't have those.

Hope that helps ...

CC

[Ms skinniness 3,003]

My insurance company approved me but then said we had to lose about 20% of our weight and when I was referred to my bariatric surgeon, they told me my BMI was too low. However, since I was diabetic, they were able to do the surgery anyways. It was so discouraging. I have a sleeve now and am doing great! Congrats on your decision and keep on rockint too your sleeve. It is a life saver.

[andersonlj 32]

congratulations on your own weight loss. Each insurance is different in their criteria. I would check with your surgeon and their office could tell you more information as they deal with all insurance companies and usually know all of the answers to questions regarding you criteria to meet. best of luck

[Last Chance Sue 4]

My doctor told me it was based on the initial weight. I have Blue Cross Blue Shield and my policy allowed a BMI of 35 if 2 or more co-morbidities were present. Since I have diabetes and sleep apnea I was approved no problem. My BMI was 39

[Rootman 1,101]

As others have said, check with your insurance programs requirements, the BMI and co-morbidities are usually required.

BUT, if you are successfully losing weight WITHOUT the sleeve why don't you continue to try it instead? YES, the sleeve is da' bomb but it is mainly for those who CNNOT lose weight any other way/ I see sawed my way up to 375 pounds and caold not lose any more than 20 pounds, and then pack 30 more on afterwards.

Just an idea.