Im at 40 BMI and insurance says that is cut off but have me on 6mo healthy weight phone coach

[lockhb 19]

So do I try to lose weight go below cut off? I'm half way through and have lost 7lbs..
Has anyone else gone through this? My family DR said don't lose anymore until insurance approves. I just wondered if I don't show ive tried if they will turn me down. VERY frustrated playing the game

[lthueme 66]

I totally understand your frustration! I was in a similar situation but I had to make monthly doctor appts for 6 months. So I stayed at about the same weight, just fluctuating up and down. Just try and play their game and you will get through it.

[SnowDaisy 73]

Why not ask them straight up. Get them to put it it writing too. You have the support and records of your general physician. Surely, his or her objection to this six month regime should carry some weight...(pardon the pun).

They know the date you started this and they know your start out weight and BMI so surely your start BMI will count.

Hope you get the answers and the outcome you want.

Xx

[lockhb 19]

I have a letter Dr wrote to ins company saying I needed surgery asap. The surgeon filed and I was denied. I contacted insurance 2times and talked with 2people and received two answers. One I need to be 40 Bimini and another told me they expected weightloss. I have not had anything in writing. I WILL CALL AGAIN.

[*Misty*Raine* 192]

Im also going thru this. I have a BMI of 36, but also have many comorbidities. My insurance is known to deny for not having a high enough BMI. My dr told me that he was not able to tell me to "gain weight to make criteria" but that if I did, "it would help get me qualified" So that being said.... I had to gain like 10lbs.... but that is harder than one would think when u already have the losing weight mind set. Ugh!

[kristysue 0]

I have been having the same issues. I was denied surgery after 6 mos because I did not have comorbidities. Resubmitted twice and they still denied. I am starting over again. But I intentionally gained 20 lbs to spike my sleep apnea. I had to take the test and then report that I cannot use the CPAP to control my apnea. How dumb it that!

The insurance company has since approved me for the 6 mos. I have to start all over again. I have to attend nutrition counseling, get a psych eval and lose the 20 lbs I had to gain. It is crazy what one has to do to get insurance coverage. Before I started this whole process I had to have my lapband removed. So I am hoping the third time is the charm.

[lthueme 66]

It just makes no sense what we have to go through. Good luck to you!

[angiev8159 0]

I have the same problem. I live in Kansas so do they make you go to their dietary at the hospital or do u find your own