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Anyone denied with BMI of 39.9?



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Has anyone been denied by their insurance for having a BMI of 39.9? I have no co-morbidities, so my insurance (Blue Shield of CA) requires a BMI of 40 to approve the surgery, and next month will be the final month of my 6-month supervised diet so I was hoping they'd be able to submit. I'm 5'8" and at my last weigh-in I was at 262.5 - a half-pound off! Since my last visit I have had my gallbladder removed and have lost a few pounds (and at my last visit I wore really heavy clothes, left my shoes on and kept my keyes in my pocket), so I know I will be further away today. This part frustrates me to no end...

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Drink lots of Water before you weigh in and have a. Salty meal the night before you'll be ok

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It is my understanding that they use your starting weight. But it doesn't hurt to guzzle some Water and keep your shoes on before you weigh in.

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can you get some lead weights and sew them into the lining of your clothes? I know this sounds ridiculous, but maybe some lead fishing weights...couldn't hurt :*(

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I personally don't know whether they use the starting BMI or the current one but knowing how insurance companies are if the guideline is 40 and you are 39.9 they would deny you because they don't want to pay for anything they don't have to. So, while I personally would never advise anyone to commit insurance fraud by sneaking extra weights in your pockets, I would recommend trying to find a way to get your weight up enough for the weigh in even though it seems counter productive. Good Luck.

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Did they measure you at 5'8" or is that what height you have always been and gave them? Only asking b/c I have been saying I'm 5'7" my whole adult life, but I am now only 5'6" and 3/4 inches. While I qualified at either height, you may want to have them check and if it's not exactly 5'8", that may help push you closer to 40.

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I was A little below 40 BMI and worried and gained 6 pounds! For nothing! they accepted me

At 39.5 0_o

Also have bc/bs

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Mine was 37 but Aetna approved it

Sent from my iPhone 5 using VST

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Scared to death that I'll lose weight and get denied. I'm right at 35 BMI. Nut told me not to lose any weight. They can't submit to insurance until March.

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can you get some lead weights and sew them into the lining of your clothes? I know this sounds ridiculous' date=' but maybe some lead fishing weights...couldn't hurt :*([/quote']

Amy, I put a cell phone in both pocketsat one of my weigh-ins, wore high heeled boots each time. LOL! Getting sleeved on Feb 26.

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Blue cross likely will not deny you. They are the easiest from what I hear. My surgeon told me that they actually take into consideration that u lost a few pounds through the process it shows them u are serious and will be a success--they won't be turning around to convert u later and they won't worry so much about u complicating things by not following the plan. Good luck

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Scared to death that I'll lose weight and get denied. I'm right at 35 BMI. Nut told me not to lose any weight. They can't submit to insurance until March.

Quick update I gained 3 pounds by my authorization visit on 2/13 Got my surgery date the same day Did pre-adm testing, bootcamp, and final meeting with surgeon yesterday. I can't believe I started this process on 1/21 and will be sleeved on 2/26!

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I was at 40 BMI (with no co's) when I started and have lost some weight in the process. I freaked out and called my BCBS FED and they say they go by my first visit. They also said me losing weight shows them I am committed to the change in life style. Best of Luck to you!!

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