Weight submitted to insurance

[AnaLaura85 32]

Hi everyone I wanted to know if you guys knew which number was submitted to the insurance, was it the weight from the first appointment with surgeon or the one right before it's submitted? I want to lose 20-30 pounds but I don't want to screw myself in the process if that would bring down my bmi and cause them to deny me. Doctor told me he didn't require me to lose any weight preop it's me wanting to just curious to see if anyone knew.

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[kmorri 1,689]

All of my weights prior to insurance approval were submitted.....I had to ensure I stayed above a 40 bmi until it was submitted to insurance. Mine was submitted and now I start my two week diet on Monday so I'm free to lose weight now. I felt the same as you I wanted to start loosing but couldn't. Good luck!!!

[AnaLaura85 32]

All of my weights prior to insurance approval were submitted.....I had to ensure I stayed above a 40 bmi until it was submitted to insurance. Mine was submitted and now I start my two week diet on Monday so I'm free to lose weight now. I felt the same as you I wanted to start loosing but couldn't. Good luck!!!

Thank you I figured that if I lose that much now it would put me under, guess I have to be patient and wait. I go see my surgeon in 2 weeks by then I will have finished all the preop testing and psych evaluation, hopefully they are ready to submit. Good luck with your journey it's getting close to the beginning of the rest of your new life yay

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[Womanvsmirror 314]

i have been holding on to a 41 bmi for 2 months, ugh paperwork should be submitted by tuesday. Also frustrated i wanted to hit onderland before surgery but was told at my last appointment surgery will be cancelled the day of if my bmi is to low, and all my weights are submitted because Aetna requires no weight gain so they have to see the progress through the 90 days

[AnaLaura85 32]

i have been holding on to a 41 bmi for 2 months, ugh paperwork should be submitted by tuesday. Also frustrated i wanted to hit onderland before surgery but was told at my last appointment surgery will be cancelled the day of if my bmi is to low, and all my weights are submitted because Aetna requires no weight gain so they have to see the progress through the 90 days

I'm at 40.7 bmi and can't go under 40 because I have no comorbities I have pcos which in part the reason I can't lose weight but not taken into consideration. My weight fluctuates between 230 and 225 I feel like I have to eat a lot or wear heavy clothes every time I go to my appointments it's annoying because at this point I just want to lose this weight. Good luck to you .

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Edited April 30, 2016 by AnaLaura85

[Womanvsmirror 314]

It's very annoying I think trying to maintain a BMI is crazy definitely

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[AmberMc03 59]

@@Womanvsmirror does Aetna require you to stay above 40 BMI until the day of surgery? I just dipped down to 40 and I have 1 more weigh in before submission to Aetna and then a good 30 days before I can have the surgery! Plus a 2 week liquid diet will definitely make me drop lbs!!

[Womanvsmirror 314]

I don't know if it's Aetna requirements or the surgeon I would call and ask your doctor's office. For me I'm not even allowed to do the liquid diet I would have to do 2 shakes one meal and then liquid for only the 48 hours prior to the procedure because they don't want me to lose anymore weight

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I think some people are concerned about not getting paid which is silly because if you get pre-authorization go weight on the day of surgery should not matter at least that's how I look at it but I'm going to do what they told me to do

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[Rainy Days 73]

every insurance is certainly different. My insurance required my first weight from the first doctor visit to be submitted (and it had to be over 40 BMI). And then they require I lose 5% of my body weight in 90 days, which puts me under 40 BMI and is okay. That weight will also be submitted to my insurance. If I don't lose the weight, I do not get approved for surgery and there is no second chance.

[Womanvsmirror 314]

Yeah the rules are all over the place mine doesn't require to lose weight but you can't gain 1 pound they do suggest that you lose 10% of your excess body weight

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[AnaLaura85 32]

Crazy how everything is different I'm gonna maintain for now and see what the surgeons office say when I go back in 2 weeks.

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[Iisa8181 6]

This is exactly my question also.Does anyone know how federsl bcbs is? Day of appointment or surgery BMI

[Teapot 26]

This is exactly my question also.Does anyone know how federsl bcbs is? Day of appointment or surgery BMI

It would be great if there was a thread about this. I'm very confused by my insurer's requirements too.

[Rainy Days 73]

This is exactly my question also.Does anyone know how federsl bcbs is? Day of appointment or surgery BMI

It would be great if there was a thread about this. I'm very confused by my insurer's requirements too.

Probably the best thing to do would be to call your insurance company and ask them to direct you to their complete policy about weight loss surgery. My insurance company mailed it out to me and it completely spells out the requirements and the weight amount (and in my case, the required amount to lose prior to surgery).

[AmberMc03 59]

Look for your insurance company's clinical bulletin regarding gastric or weight loss surgery. It should explain the requirements in detail. Aetna (Texas) is #0157.