bmi 41 and can't drop under 40 on pre-op program

[Dmog74 2]

Is anyone else in the same situation? My BMI is 41.7, but I'm only 5 feet tall. A matter of 8-10 lbs will knock me below 40. I have to do a 6 month weight management pre-op program in which my weight is not supposed to go up any. I have no comorbidities, as far as the insurance is concerned. My former insurance accepted my diagnosis of sleep apnea as well as tested me for CPAP which I needed. When I switched carriers Jan 1, the new carrier says it's not significant enough and will not pay for CPAP (go figure)! I am very nervous that I will do my 6 months and fluctuate in weight or that even though my BMI will be above 40 with no comorbidity according to them, they won't approve. Anyone else been in this situation??

I worry because I can fluctuate easily between 10 and 15 lbs. HELP!!

[HHHappy 225]

What exactly does your policy state. For example, I had to be above 40 bmi for the last two previous years. So if you drop below that during your weight loss phase, perhaps it won't matter if you've been above 40 for previous years. Call your insurance company and ask about it.

[Dmog74 2]

unfortunately they look at weight from initial consult and then every month therafter until the 6 months is finished. If you drop below BMI 40 during any of those months, they wont cover

[Madam Reverie 2,958]

Seems like you have to keep eating to keep it up for the period of time...

[jsurles 3]

I can totally understand your frustration. I too have had to maintain a bmi of 40 for six months. My highest bmi is 40.7. I am 5'6 1/2 tall and weigh 253.4. I have spent the last 7 months maintain my weight by doing Portion Control, very little exercise and praying. I am borderline on all co-morbidities. I am now waiting for insurances approval or denial. I have done everything the doctors have asked, I just wait and try and fight the depression that goes with this insurance thing. I have found no for sure answer, I will keep trying whatever it takes. and you should also. I see people on different forums, who fly thru the insurance thing, its really worrisome. Just keep trying.

[FitnFabfor2014 358]

Hi! It's so funny how different insurance companies are. I also had a six month requirement. My starting BMI was 40.5 (no co-morbidities) I had to lose at least 10% of my weight prior to surgery. I lost 15lbs and I was really concerned about them not approving my surgery because I was under the required BMI. I found out my insurance company goes off your initial weigh in with the doctor, everything after that is just logged in (as progress or not). I didn't lose anything for the first three months. It wasn't until my last three months that I upped my Protein shakes to two a day then I started to lose the weight. Maybe you can double check that the insurance company only looks at the first weigh in. Hopefully everything after what you lose will be an extra bonus.

​ Good luck!!!

Edited March 2, 2014 by FitnFabfor2014

[Photo925 100]

I would ask the insurance company. I have a similar situation and when I asked about dropping weight while in my six months of classes, they said that it would not matter if my BMI drops below 40. I also do not have any co-morbidities