BMI and Insurance

[BeachMommy2Girls 6]

Hey everyone! I'm new here and just starting out on my journey. My question is - right now my BMI is 41. If I drop below 40 during this process (I don't have another qualifying condition) will insurance deny my surgery?

[olamae 16]

I have asked this same question and I have been told they go by your starting weight. How long do you have to go through with insurance?

[BeachMommy2Girls 6]

7 months!!! [emoji849][emoji849][emoji849]

[dg371 50]

I was told not to lose any weight. I am barely 40 bmi

[aftermath 13]

You wear very heavy clothes to that weigh in!


Sent from my iPad using the BariatricPal App

[hotmamma1979 42]

I fell below 40 and was approved with no comorbities .

[dg371 50]

I'm sure it just depends on your insurance policy requirements.

[BeachMommy2Girls 6]

I was told I have to maintain the 40 BMI. I have Blue Cross Blue Shield of Alabama.

[nh-vsgirl 102]

My Dr doesn't submit your starting weight for approval buy what you weigh right before they are ready to submit for approval. Which sucks because I'm 40.1

[cbyrum 2]

I was only at a BMI of 42 when I started the process in march 2016 and was told to try and lose weight that the weight submitted to my insurance company was my weight from my first visit not the weight right before surgery. So even if I lost 30 lbs and went below the 40 BMI mark I would still be approved by my insurance because they wouldn't be the wiser to the fact that I had lost weight to go below that.

[cbyrum 2]

My surgery wasn't until December 2016 btw

[snarkysheltie 1]

This is nerve-wracking, but I see I am not alone!.....I'm just over 40 also and my insurance is requiring 6-months doctor supervised dieting....and of course they have not said what weight they will go by. I don't have my first phone consult with the insurance's bariatric nurse for 3 weeks. Hopefully I can find someone on here that went through that with the insurance I have. Good luck to everyone!

[Diana_in_Philly 1,426]

@snakrysheltie Instead of stressing, call your insurance company. Mine was great about answering questions during the process. I was approved 2 days after the materials were sent - in fact - I got notice of my approval from my insurance company before my surgeon's office. What matters is what your carrier does and not what anyone else's has done - and what they do on your policy. You could talk to others who have the same insurance co but have a different policy and the process could be completely different. Good luck!

[snarkysheltie 1]

@Diana_in_Philly, that is great (and sane, lol) advice! I've noticed too with my carrier that it also depends on who I speak to on their helpfulness....which I guess goes for just about anywhere, tbh. The last person I spoke with basically gave verbatim what was already available in the policy documents already available online, but that doesn't mean the next person won't be helpful. I have spoken to great people there before, albeit on different topics.

Thank you!!!