Brandigirl 22 Posted May 7, 2016 HI everyone! My name is Brandi, I am 32 years old from Phoenix, AZ. I got the lap band 10/2013, over the next year I lost almost 80 lbs. In 01/2015 I had to have my band emergently removed due to complications. After that I tried to get approved for the Lap band to gastric bypass conversion . I was denied as I didn't have a high enough bmi or any comorbidities. Over the next year I managed to gain all of my weight back plus a little more so I am now in the process of getting approved for bypass, (I currently have a bmi of 38) My insurance (of course) denied me right away because high cholesterol isn't a comorbidity and my bmi isn't over 40. I was about 15 lbs away from my bmi just over 40, so I decided to gain that weight (i know not the best idea but hey gotta do what you gotta do.) I have called my surgeons office to see what the next step is but have but heard from them. Does any one know, do I need to appeal it still or just go get weighed in at the surgeons office to prove I am at 40 now? Thank you for reading. Wish me luck! I need this! Share this post Link to post Share on other sites
pammieanne 269 Posted May 9, 2016 I bet it all depends on your insurance company. I knew about the BMI expectations/ approvals before I went to see my doctor for the first time. I too was about 17lbs too light... I gained that before going to see my doctor. Let us know how it goes! good luck Share this post Link to post Share on other sites
Brandigirl 22 Posted May 9, 2016 I'm glad I am not the only one who has done this. Hopefully I'll get some answers this week. When was your surgery? How are you doing? Share this post Link to post Share on other sites
pammieanne 269 Posted May 9, 2016 My surgery date is May 16th. I started my pre-op diet last week, and go to all liquids on Friday. I'm very excited, and starting to get a little nervous too! LOL But it's all good, I hope! Share this post Link to post Share on other sites
Brandigirl 22 Posted May 10, 2016 Oh awesome!! I wish you the best of luck and can't wait to hear how it goes! Share this post Link to post Share on other sites
pammieanne 269 Posted May 10, 2016 Thanks! I am getting nervous, but I know that's normal. I just want to get through those first weeks where it seems some people are so miserable! LOL I hope I'm not one of them Have you decided how you're going to handle your insurance? I think you should just go in and see your doctor, and let his insurance advocate handle it the best way they know how. They're good at stuff like that. Share this post Link to post Share on other sites
Brandigirl 22 Posted May 10, 2016 That is perfectly normal to be nervous. I am kind of nervous and I don't even have my surgery scheduled. I finally got a call from my surgeons office yesterday, I think she is a bit annoyed with me ???? she didn't really tell me anything I already knew. She says to get a sleep study done, which is in the works but I'm pretty sure I am at weight my bmi needs to be. So I'm not sure what is next. Share this post Link to post Share on other sites