Low BMI

[wc_lady 0]

I was just wondering if there is anyone or someone you know that got insurance approval with a 35 or lower BMI and some Co-morbidies.

I am on the fene as to whether or not I should.

I weigh 213 and want to be 140. 5fT 6 inches tall 52 years old.

TIA

[wc_lady 0]

High Blood Pressure,

High Colestrol,

Acid Reflux.

[wc_lady 0]

Thanks, I hope so.

I need to gain a few pounds to hit the 35 bmi.

TIA

[wc_lady 0]

I haven't checked with insurance yet.

I was just going to get all info I could together and submit.

I see PCP tomorrow for he's recomendation letter and files.

Had surgeon consult and have a letter from him stating

it would benefit my health to have the band. Had the pychco

exam. I will start the 6 mo. supervised tomorrow with PCP.

Hopefully everything wil fall into place.

TIA

[disney38 0]

but will tell of my experience. I was denied by my insurance (BCBS) because my BMI is not 40..it was 39 when we submitted for approval. I had just been diagnosed with sleep apnea prior to submitting.

They denied my request and the appeal because:

BMI greater than 35 and less than 40 would be considered with comorbid conditions. They did not count my sleep Apnea because it was controlled by CPAP. I had only had it 2 weeks, and had no time to see how it is working...it is not.

At any rate, since the denial (8 months ago) I had some other health problems and left this be. Two weeks ago, I called my insurance company and they said i could resubmit ONLY if something changed. So I asked them about the sleep apnea not being controlled, they told me that did count.

Now I do have high blood pressure and high cholesterol - they won't count it because I am not on medication. If I go on medication, they won't count it because it will be controlled.

The surgeon is submitting for the sleep apnea, but if this fails again, I am a self pay to Mexico.

[Sophie248 0]

I was approved by BCBS with a BMI "just barely" 35 and high blood pressure. I had to gain a few lbs also, but glad I did. I would have never gotten my overeating under control without my band. I had tried for 19 years.

[fabfatgrl 10]

I'm a little worried that you're considering the Band when you already have Acid Reflux. A lot of Bandsters end up with reflux issues post-banding... so you may want to talk to a surgeon about that.

As for insurance, I've yet to hear of an insurance company approving with a BMI below 35. BUT, there are studies going on right now on lower BMI Bandsters... so perhaps there's hope??

[wc_lady 0]

Sophie248 did you have a supervised 6 month WLS history? I also have BCBS.

I do suspect a hiatal hernia, mentioned it to surgeon, he will test for it before he does a band. He said my acid reflux should be cured with the band. I do hope I can get this band. I also have a over-eating problem I cant seem to control.

I love this forum I have learned so much here.

[Sophie248 0]

Sophie248 did you have a supervised 6 month WLS history? I also have BCBS.

I do suspect a hiatal hernia, mentioned it to surgeon, he will test for it before he does a band. He said my acid reflux should be cured with the band. I do hope I can get this band. I also have a over-eating problem I cant seem to control.

I love this forum I have learned so much here.

No I didn't have to have a supervised 6 mo diet history. but I did have to list all the things I had tried. I have BCBS federal.

[fabfatgrl 10]

The band actually resolves Reflux for most people.

I haven't seen that in the six years I've been Banded. I know quite a few people, far down the road, who've had to go for complete unfills due to reflux... or have fill removed due to reflux. Even the poll on this site, shows more than 60% of people experiencing reflux issues if they've been banded 6 months or more.

http://www.lapbandtalk.com/poll.php?do=showresults&pollid=89

May not be a scientific poll, but I can definitely say that I've seen at least 50% of people who've been Banded long-term (at least 18 months) and are filled having reflux issues. Most end up trying small unfills or total unfills to try and let things heal.