Just missed the BMI of 40

[gibsonsmom 4]

I went to my first appointment with my surgeon today. I missed the BMI of 40 by 0.8 pounds! 0.8lbs! I thought I was going the hiatal hernia route to bypass insurance, but Cigna requires me to use my bariatric benefits. Had I known that, I would have worn some ankle weights. I'm so upset! I have high blood pressure that I'm on meds for. That should be a good enough co-morbity right? Did anyone with a BMI less than 40 and the hypertension co-morbity get approved? The Cigna policy is vague so I called them and they were no help. Surely they don't want people to walk around with uncontrolled hypertension. I'm probably going to just start over with another surgeon. I can't be stressed out for the next 3 months over 0.8lbs.

[careya123 260]

This is terrible, but...can you have a few donuts and go back to the same surgeon? Most people are up and down within a few pounds the same day depending on Water and the food they've eaten. Seems crazy to cut you off.

[IrishGermanRN 151]

This happened to my mother. Her pcp said to go down the street and order a huge burrito and come back after.. She then made the weight

Edited February 19, 2016 by IrishGermanRN

[Jennaluv 15]

I went to my first appointment with my surgeon today. I missed the BMI of 40 by 0.8 pounds! 0.8lbs! I thought I was going the hiatal hernia route to bypass insurance, but Cigna requires me to use my bariatric benefits. Had I known that, I would have worn some ankle weights. I'm so upset! I have high blood pressure that I'm on meds for. That should be a good enough co-morbity right? Did anyone with a BMI less than 40 and the hypertension co-morbity get approved? The Cigna policy is vague so I called them and they were no help. Surely they don't want people to walk around with uncontrolled hypertension. I'm probably going to just start over with another surgeon. I can't be stressed out for the next 3 months over 0.8lbs.

I'm with you, try an other opinion, and get tested for other co-morbidities, especially sleep apnea. Keep pushing, my insurance has denied me 4-5 times regardless of me jumping through every hoop they held up, and kept deeming it "not medically necessary." What turned the corner was both my persistence and the team at my surgeon's office. Ask for appeal, ask for a supervisor, and ask them to be clear about exactly what their insurance requires for approval. It's frustrating, but I know you can do it. We are our best advocates

[sharonsjourney 16]

Unfortunately I had the same issue! I had to have a sleep study. Usually sleep apnea is the key.

[xochtlem 54]

Is it possible they put your height down wrong?

No seriously, I ask because all my life I've believed myself to be 5'6" (and a half lol), and when I went to my first surgeon consult, they asked my height. They never measured it. But when I switched surgeons, they measured my height and I was 5'5, which made a difference in my BMI by like 2 whole points.

Edited February 19, 2016 by xochtlem

[reinventingmyself 47]

I hate how all insurance requirements vary so drastically. I had 35 bmi and dr. sent in referral for high blood pressure. That was my only comorbidity and it is controlled with just a dieuretic. I was approved no questions asked. I have tricare insurance but they didn't cover sleeve (in Dec. when referral was submitted). So hospital on military base is covering it 100%. But please don't give up. Eat a big Breakfast and go back and get weighed. Don't let .8 stress you out.

Sent from my SAMSUNG-SM-N920A using BariatricPal

[MeFirst 65]

Definitely see about another weigh in! Don't give up. Cellphones and keys in pockets, wear jeans, and have a bladder full of Water. That will definitely push you over the .8 lbs.

just make sure to excuse yourself to empty your bladder before the Dr comes in to chat with you. [emoji6]

[Tobeornottobe 89]

I went to my first appointment with my surgeon today. I missed the BMI of 40 by 0.8 pounds! 0.8lbs! I thought I was going the hiatal hernia route to bypass insurance, but Cigna requires me to use my bariatric benefits. Had I known that, I would have worn some ankle weights. I'm so upset! I have high blood pressure that I'm on meds for. That should be a good enough co-morbity right? Did anyone with a BMI less than 40 and the hypertension co-morbity get approved? The Cigna policy is vague so I called them and they were no help. Surely they don't want people to walk around with uncontrolled hypertension. I'm probably going to just start over with another surgeon. I can't be stressed out for the next 3 months over 0.8lbs.

I have Cigna and was approved with a BMI of 35 with co-morbidities. If you're under a 40 BMI, Cigna requires at least one co-morbidity and hypertension is a co-morbidity that qualifies.

By the way be careful with the 90 days. As far as the medical management part, I wanted to be very careful so I did 100 days to be sure. I've seen people get denied over the time thing and have to start all over.

In the meantime, I would advise you to start all the required testing.

Good luck.

[gibsonsmom 4]

Thanks for all of the words of advice everyone! I had to wait an entire month for this appointment and they won't schedule my EGD until I've completed the 90 day medically supervised diet. The medical assistant that calculated my BMI laughed and said "oh, 39.9!". No offer to re-weigh or re-measure or anything. I'm going to see another surgeon and they can get me in next week to start the process. Hopefully this office won't be as busy so I can get my surgery done faster after I jump through all of the insurance hoops.