Insurance Approvals / Technicalities for Low BMI Bandsters?

[gin765 49]

My BMI is currently 34 - 36, depending on the chart, with my insurance company requiring a minimum BMI of 35, plus at least 1 co-morbidity. Is there an "official BMI chart" somewhere? The one that keeps coming up when I Google it is a Metlife chart from 1999.

Coverage details the insurance company sent me seem a bit nebulous (I imagine that's not an accident). Since I'm right at their 35+ BMI requirement, would they fault me for not losing and/or gaining weight during their required 6-month supervised diet and exercise program? Did I mention how excited I am that the past 22 years of documented Weight Watchers, Jenny Craig, Nutrisystem, etc. failures, with weight steadily increasing is not sufficient??? I've already spent enough money to pay for the surgery myself! But, I digress...

Anyway, once you have the insurance company's approval, can you drop below the specified BMI (35), on the pre-op diet, or will that disqualify you? I don't really want to ask the insurance company too many questions yet, so they can start compiling reasons to deny me. I understand all companies/policies are different, but I'm curious what experiences others have had. Specifically, I have Highmark BCBS of PA.

Thanks!

[sunflowerchild 146]

In my experience, yes, Once the insurance company approves you, yes you can drop below the qualifying weight (assuming your dr will still do the surgery). I was at 34.8 BMI (w/1 co morbidity) and was lucky enough that the office staff got the insurance to approve it. By the time I had the surgery my BMI was around a 33.8

Edited September 30, 2014 by sunflowerchild

[2muchfun 8,927]

Don't be vain about your height if they're relying on your own height testimony? For instance, my daughter is 4' 11.5". She says she's 5 ft tall but she's not. If your rounding up, don't. Round down. 1 inch can make a big difference with your BMI.

[iheartz 12]

For me, I was exactly at 35% with 2 Co-Morbidities. My Insurance approved my surgery at my official weigh in at first apt. They still covered my surgery when my BMI was at 33% on day of surgery. Make sure your height is correct it does make a difference. I used to be 5'7 back in the day and when they weighed me in and got my height at first apt I was suprised to learn I have shrunk to 5'5 1/2. Good luck with your journey! Buy the way My Ins is BCBS PPO. And I didn't have to do a 6 month pre-op diet. The only diet I did was my 2 week pre-op per my surgeon.

[gabita 8]

My insuranxe covers low bmi wls only if I have a medical issue. Which I don't have thank god so I'll pay for my lapband