Brand New Ready But Qualify

[TimeIsMine 10]

So...my BMI is 33, and my surgical clinic has not yet said "No". Gone to the Nutrition class and now getting clearance from my pcp. Have HBP and Hchol. Here is hoping they take me! 80-100 g of Protein is a struggle

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[jane13 2,256]

@@TimeIsMine which surgery? I am assuming sleeve, that's a really low BMI. what is Hchol, high cholesterol?

good luck, keep posting:)

[TimeIsMine 10]

Yes high cholesterol. Am taking in the required 89-100g of Protein - hope they don't tell me my BMI is too low. What are your thoughts? I am 73 lbs over my ideal weight.

TheStruggleIsReal

[TimeIsMine 10]

Being 73 lbs over my ideal weight should qualify me right? BCBS has approved coverage with no restrictions, so I am now working on getting the bone density test completed.

TheStruggleIsReal

[Dawnie Doo 184]

Being 73 lbs over my ideal weight should qualify me right? BCBS has approved coverage with no restrictions, so I am now working on getting the bone density test completed.

TheStruggleIsReal

It really depends. My doctor stated that the lower BMIs need to have medical concerns, which you do. So your insurance company will hopefully recognize that.

Dawnie_doo

[TimeIsMine 10]

Yes. My BP and high cholesterol. My hope is that my numbers go down and I can come off the statins

TheStruggleIsReal

[kmorri 1,689]

@@TimeIsMine I don't want to be a Debbie Downer but the most common coverage guidelines is greater that 40 BMI, or a BMI of 35 or more with commodities....I'm afraid your BMI is going to be too low.....in fact some insurances exclude coverage for BMI's of less than 35.....But then again, you never know! I wish you much luck!!!

[LisaMergs 2,854]

Being 73 lbs over my ideal weight should qualify me right? BCBS has approved coverage with no restrictions, so I am now working on getting the bone density test completed.

TheStruggleIsReal

BCBS is amazing in their coverage and quick response.

[TimeIsMine 10]

Great, I have not heard otherwise so I hope I'm a go

TheStruggleIsReal

[VsgFitMom15 0]

You'll probably be turned down ,you need to be able to lose 100 pounds & stull.be at a safe & healthy bmi !

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[cindyw41 761]

What does your surgeon office say are your odds of getting approved? Have you called the pre authorization department with your insurance? Ask them what the criteria is.

[TimeIsMine 10]

Sry for delay in response. Surgeons office said I was approved and only had to meet my deductible. Still waiting on my referral for bone density scan....like watching paint peel. I have resigned myself to defeat (thanks Debbie Downer) on the sleeve, maybe they will approve the band. Thoughts?

TheStruggleIsReal

[cindyw41 761]

There is a lot of issues with the band. Most surgeons do not even offer them anymore. Why are you not sure of the sleeve?

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Edited April 21, 2016 by cindyw41

[TimeIsMine 10]

Just worried my BMI will not be high enough. 33.3 with health issues

TheStruggleIsReal

[kmorri 1,689]

I don't understand and I'm a little confused.....you said they say you're approved in this post.....approved by your insurance?

Sry for delay in response. Surgeons office said I was approved and only had to meet my deductible. Still waiting on my referral for bone density scan....like watching paint peel. I have resigned myself to defeat (thanks Debbie Downer) on the sleeve, maybe they will approve the band. Thoughts?

TheStruggleIsReal

But here you say you're worried your bmi isn't high enough.....so are you not approved?

Just worried my BMI will not be high enough. 33.3 with health issues

TheStruggleIsReal

The normal process is you see the surgeon.....they do an initial evaluation. If they believe you'll meet the insurance requirements they coordinate all the the required testing and educational classes required.....and when all that's completed then they submit all your paperwork to the insurance for approval. Has any of that been done?

Edited April 21, 2016 by kmorri