41BMI now, but if I lose weight, will insurance still approve me in six months?

[MetroDetroitChic 86]

Starting off with a BMI of 41ish. Working with PCP and NUT and I am really liking the new lifestyle and feel great....And am losing weight. At the end of the six month mandatory wait, I will surely have a BMI less than 40.

I know I have the ability to lose weight (have lost 50+ lbs twice in my life, regaining both times). So I would like the sleeve as a tool to keep the weight off. (Husband and I are both doing it).

Anyone have a similar experience (BMI under 40 with no co-morbidities) at the time of application and still get approved?

Thank you!

[TBodmer71 245]

Yes, I started with a BMI of 43. But had a BMI of 39 just before surgery. The way the paperwork is submitted to your insurance, they go by what your starting BMI was when you started the whole process for WLS.

So as long as you met their criteria at the beginning you should be fine. Although, always double check with your insurance carrier or bariatric team directly.

[adargie 159]

My insurance was different, I had to stay at a BMI of 40 and could not drop below it or they would deny it. I was exactly 40.4 my first weigh in. So I had to go 6 months without losing more than 3 pounds and not gaining either, it was nerve wracking. But I did it and was sleeved 8/5. My surgeons office was very knowledgeable about what my ins would approve. I also called my ins and recieved a packet regarding bariactric surgery and requirements but it never stated about dropping below 40 and no comorbs

[SuNMooNStaRS816 423]

If you have comorbs you will still be approved if you lose wgt. If you do not....you run the risk of not being approved if you drop below the BMI. My surgeons office specifically told me "do not lose or you will be denied."

[MetroDetroitChic 86]

My insurance was different' date=' I had to stay at a BMI of 40 and could not drop below it or they would deny it. I was exactly 40.4 my first weigh in. So I had to go 6 months without losing more than 3 pounds and not gaining either, it was nerve wracking. But I did it and was sleeved 8/5. My surgeons office was very knowledgeable about what my ins would approve. I also called my ins and recieved a packet regarding bariactric surgery and requirements but it never stated about dropping below 40 and no comorbs[/quote']

I was told two things by my Bariatric team: "insurance coordinator" person advised me not to drop below 40BMI. my doc said the first weight was all that mattered and that insurance companies like you to demonstrate that you are going to stick by this new healthier lifestyle, and she added "so lose all the weight you want".

Very confusing. But common sense tells me I will listen to the doc, try to lose weight and become more healthy... This is what this is all about now anyway.

I just will be soooo mad if by losing lots of weight I wind up denied for the surgery.

[bigbeauty78 27]

My office submits your first weight only.

[unbesleevable1 420]

It totally depends on your insurance, because I have heard so many variations of this question. Talk to the insurance coordinator, because she is the one that is dealing with many different insurance companies, and will know the most about the process. If you ever get to choose your insurance, I am fully recommending Anthem BC, because their pre op requirements were very easy, and approval was less than a week. No 6 month diet! Also the Orange Coast Center for Obesity has been an amazingly well-oiled machine, and I have been very impressed. My BMI is barely 40, and I have no comorbs, so I was kind of unsure if I would get approved. At the first appointment, they gave me a huge binder, and took my 'before' picture, and I was like, 'hold on, guys, don't cha wanna wait til I get approved?'. They knew what they were doing. check out my signature! The only reason for the Nov Surgery date is because I have to finish a big project at work before I can take off. They wanted to schedule me for sept 30!

[FitnFabfor2014 358]

Yes, I agree. It all depends on your insurance company. Mine (Health Net), said it's based on your first weigh in. They (the Dr 's) want to make sure you will maintain a healthy life style after the surgery. I am right at the border with my BMI (40) with no comorbids. I have started drinking the Protein Shakes for Breakfast to prepare myself for the liquid diet. Fingers crossed!!!