I don't have 5 years of a BMI of 40!!

MrsAEF · May 29, 2007

Hi everyone! I'm highly interested in getting "banded" and I called my insurance company (UHC) to see what the requirements were for me to get approved for the surgery. They said....

-I need to be 21 or older. Check

-Have a BMI of 40 or higher. No check, my BMI is 38 and only 10 lbs will get me to 40. Maybe I should drink lots and lots of Water and wear heavy clothing on my weigh-in!:rolleyes

-I need to have documentation that I have been morbidly obese for the past 5 years. No check, I'm a yo-yo dieter so there have been times where I was 160 lbs within the last 5 years and this weight has obviously, decreased dramatically since then.

I'm feeling a bit discouraged because I meet only one of their requirements but at the same time, I'm not going to give up. I'm going to start the journey and hopefully they will see that just because I don't have diabetes or high blood pressure, I'm still physically unhealthy and dieting just isn't working for me.

Anyway, do you guys have any tips or advice before I get started on this journey?

Alexandra · May 29, 2007

At this point, MrsAEF, banding is only covered by insurance as a treatment for chronic morbid obesity. However helpful the band may be as a preventive measure, and however much it will help yo-yo dieters gain control and health, the medical guidelines say that bariatric surgery is not a worthwhile risk for anyone who doesn't currently qualify medically. And that's the yardstick the insurance industry uses.

This may change, but for the time being it is what it is. Without comorbidities and the history of being MO, it's a million to one chance that your carrier will cover it. But they have to draw some lines because for every borderline person who is turned down there is another much heavier person who needs and is getting the coverage.

Prices are dropping all over, though, so going self-pay may be more accessible than you think. Good luck!!