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No heart disease or diabetes, can I get banded?



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A newbie here!

Hi I was wondering...I have no serious health problems to date. My last physical- last yr 2006 in August I had high blood pressure, but that day the temp was like 103 in NY. So the doctor said it could be the weather and me hustling to get to the appt on time. Other than that the only issue I have is the weight..what is the chance that the insurance will approve me?!? :cry

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Depends on who you have your insurance with....I have heart disease and I had open heart surgery when I was 48 years old, and my insurance still would not pay for it...

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WHAT I WAS TRYING TO SAY!!!

Dear Luvli23,

I had the exact same problem. The only problem I had was being over weight. It does depend on you insurance. I have Mamsi (a great insurance). I said the same thing to my dr. My BMI did it alone to get my surgery covered 100%. Good luck!! Also I didn't have to wait any waiting period time for approval. I went in one day and had the surgery 3 weeks later. I wouldn't change a thing. We are just the healthiest big girl they know. good luck sweetie!!

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How much do you weigh? Rather, what is your BMI? The basic 'standards' right now are that with a BMI over 40, if your insurance covers the surgery, they'll cover yours. If your BMI is between 35 and 40, it can be a struggle to get them to cover it if you don't have any other issues caused by your weight. I don't believe I've heard of any insurance covering between 30 and 35, but there are doctors who will do it if you can pay for it.

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Hi My BMI is 36.6 and i'm 5'6 227 pounds. Just want to know the chances...i'll go through the motions and hopefully I can get banded. It all depends on the supprt of my physicians andmy persistance will bring through!!!

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With a BMI of 36.6 your insurance carrier probably wouldn't deem the surgery to be medically necessary unless you also had co-morbidities. They don't have to be heart disease or diabetes, though; there are many other conditions that can be considered. Talk to your PCP and be brutally honest, give them lots of information they can use to make the case.

But you should be aware that there are LOTS of people ahead of you, with BMIs of 40 and above. Every carrier must make decisions based on guidelines of medical necessity, so it wouldn't really be a shock if you were denied on those grounds. :)

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you don't state how much you weigh or your height...

What is your BMI?

If you have a lower BMI sometimes the doctors like you to have another Chronic condition ie. Asthma, Arthritis, Diabetes or High B/P

I am a lower BMI person 32 and I want to get to 25

so I have about 65 lbs to lose...

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Something else to look into is sleep apnea. Alot of us have it and don't realize it. The more I read about I think I had at least some case of it at my highest weight.

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