elhudge 69 Posted March 9, 2012 Went for a consultation today and was told by the nurse after taking my weight and vitals that i do not qualify because my bmi is 35.9 and i I'm healthy because I don't take medication. Since when does not taking medication equal health? Share this post Link to post Share on other sites
SexySlim 107 Posted March 9, 2012 Yep. When you are healthy and not costing your insurance company any money they don't want to pay for your surgery. I'm 280 BMI is 39 and not qualified. I need to lose over 100 lbs and I'm not qualified?!?!? That's why I'm going to Mexico in 3 weeks. Share this post Link to post Share on other sites
elhudge 69 Posted March 9, 2012 I have peripheral edema, tachycardia, arthritis, and chronic back pain! I was in the exam room for all of 3 minutes...never laid eyes on the doctor....they took my co- pay and said "sorry". Share this post Link to post Share on other sites
New1 201 Posted March 9, 2012 Yeah, that sux. When I first considered WLS (it was the lapband 5 years ago) my BMI was only 35 and I was told I didn't qualify. Now I have a week until sleeve surgery and my BMI is a 48-49 :-( I tried 7 different weight loss approaches in the past 3 years and have lost some and gained back more during that time. I hope things work out for you. 1 Larry Stuto reacted to this Share this post Link to post Share on other sites
elhudge 69 Posted March 9, 2012 Thanks. I'm not giving up, but that was a foul ball to be told that by a nurse and ti not have even seen the doctor...on to the next one! Share this post Link to post Share on other sites
Larry Stuto 6 Posted March 9, 2012 Kaiser is about the same. I went 3 years ago and they told me I had to 5'6" to qualify. So he had me skrunch down from my 5'8" 285lbs.and put me through. I lost like 40 lbs in pre-op so I backed out. Glad I did. At that time I was doing the lap band. Now I know that the long term success rate is so bad. Now 3 years later Im back, This time my BMI was 42 and weight was 280lbs. They took me no problem? I have to lose 15lbs pre-surgery. After 10lbs they make a physcology appoint. then schedule surgery and I lose the last 5lbs before. It is tough doing a 1200 cal diet but I see the end goal and keep motivated. Dont know how many times Ive walked to the fridge and turned away. I wish you success with the surgery in Mexico. I have not heard anything bad? Has anyone considered the gastric without surgery? Its a pill or drink? that expands in your stomach for 16 hrs at a time. Giving you the same feeling as having the surgery? It was advertised for $498.00 ?? I put 20 lbs on just to make sure I would qualify. I know I am not able to lose the 115lbs over weight that I am. Tried a 100 times. Good luck to you all and especially WTF. I feel your pain! Share this post Link to post Share on other sites
Queen of Crop 1,104 Posted March 9, 2012 Yikes, reading this makes me SO sad. I was self pay, so I made the decision on Oct 5th, I was on the surgical table on Oct 25th, at 204 lbs and a 35 BMI; with a 48 hour pre-op diet. (This was in Germany). But they recognized that I had been overweight all my life; had hip and knee joint problems and now I am so much healthier (down 62 lbs). I wish you all luck with the red tape; I wish insurance companies would see that in the long term, they would be better off approving these surgeries. BTW, I am now 4 months post op; and I write a weekly (Sunday) blog. It might be helpful to some of you to know what to expect. Just click on the link below and if you subscribe, I'll be sure you get each update. http://www.queenofcrop.com Share this post Link to post Share on other sites
Tana_Q 20 Posted March 9, 2012 I'm sorry OP that really stinks. Being that they took your copay it seems as they will bill for the visit. Make sure when you get your EOB that they did not bill for you seeing the doctor because you didn't! Don't even know how they can bill for you seeing the nurse or medical assistant. Share this post Link to post Share on other sites