Pre-op weightloss

[annabreke84 42]

I am worried if I lose more the 3 more pounds I wont qualify for surgery because my BMI will be under 40 i started at 258 and as of last visit i was 247. I have completed 3 of my 6 months required 4th appointment tomorrow. Does weight lost preop effect insurance approval?

Edited September 1, 2015 by annabreke84

[lsmith715 55]

I was told they submit your weight when you started the process not the amount at time of the surgery. Good luck!

[annabreke84 42]

Thank you

[Michelle Tarver 62]

It depends on your insurance. I have to have the 40 BMI on surgery day.

[cindyw41 761]

Call the pre authorization rep with your insurance company and ask. While some require you to have a BMI of 40 on surgery day others require a certain amount of weight loss on your monitored weight loss program. They're all different.

Ps: call multiple times and ask the same questions to different reps. My doctor told me to do this. While the first rep was vague in her response the second one gave great detail on hers.

[rnsamantha 352]

I was told by my surgeon not to let my BMI drop below 40 until I was approved for surgery. Since I started with a BMI of 41, this means I only lost 5 lbs during my 6 month supervised diet. After I was approved I lost 16 during my 2 week preop diet. Everyone's insurance is different. Mine had said it would be based on my initial weight--but I didn't trust them enough to risk it!

[JellyBellyNoMore 58]

Oh the insurance dance! Every insurance is different. I have to say I am preforming the dance myself. At first I was denied because I wasn't sick enough for a BMI under 40. So I appealed and I am waiting for a response. I must say I am not bellow gaining weight to get a BMI of 40, but then I will have to start the whole process again! Including my 5% weight loss.

I better get that authorization or you guys are going to get sick of my whining.

[orb7007 9]

I think it really does depend on insurance but for the most part if you drop below your qualifying BMI you may be denied. I have united and they required 6 months of counseling so by the end of my 6 months I was taking my purse and shoes and keys on the scale lol. Good luck to you!

[annabreke84 42]

Ty I have BCBS of MN i guess ill call them again n see what they say

[tamirn 90]

Anyone know how kaiser works??

[hopefullythininme 15]

@@tamirn, I asked the same question (I have Kaiser )since I am right at BMI 40 and health education people said its the initial referred weight. I will be very upset if this is not true!!

Edited September 17, 2015 by hopefullythininme

[tamirn 90]

I hear it all depends on the pcp as far as how fast the process is. Ive been hearing so many timelines and pre op preparations it would be nice if someone could share thier entire experience from start to finish dealing with Kaiser north cal. I will most likely be having my surgery done in richmond ca.

I got my referral from my doc. She set me up for lab work.. did that... now its a waiting game she said someone will get back to me. My bmi is 52!!! I am so ready to get this weight off!!!

[tamirn 90]

Oh i did the orientation already but with john muir.. but i signed up for another orientation through kaiser on September 23

[Missy2new 5]

I have juggled around 42-40 bmi for about 8 months now. I have felt so ashamed that I preferred not to help myself, but I had so many felled diet that I just didn't want to take the risk to do it on my own again. I do have a co mobility hbp but it has been controlled for a while now. I would think after my pre opt diet I will be around 199 ,so if that's ok then you should be fine.

[The Candidate 3,215]

Mine use my initial qualifying weight BMI of 45. By the time the approval came through I was at a 39 BMI, and it wasn't an issue. They encouraged us to lose as much weight as possible along the way.