Below 40 BMI on day of surgery - does this affect insurance coverage?

[El Cee 1]

Hi, Does anyone know if it's possible that insurance could decide not to cover gastric bipass surgery if BMI falls below 40 on the day of surgery?

I'm approved for Gastric Bypass and my surgery is scheduled for December 3rd but I'm worried about loosing weight before my surgery. I'm 5'4''; current weight is 240; BMI 41.2, no comorbidities. Without any comorbidities, my insurance only approves the procedure if BMI is 40 or over (which I believe is typical for most insurance). I'm worried about losing weight during the 2-week pre-op liquid diet, because I've read that some people will lose 10-15 lbs as a result. If I lose 10-15 lbs during the pre-op liquid diet, that will put my weight at 225-230lbs and BMI at 38.6 - 39.5. Is there a risk that the insurance will decide not to cover the surgery if my BMI is below 40 on the day of surgery?

I have an appointment in 2 weeks to see my surgeon again and will likely ask him about that, but wanted to know if anyone has any experience with that?

Edited November 3, 2018 by El Cee

[elcee 3,342]

From 1 El Cee to another, hi!

[Oct517 527]

It depends on the insurance. Most insurances only go by your bmi from your initial appointment. My surgeon had advised me not to lose any weight until I was approved for surgery to avoid complications.

Sent from my SM-G960U using BariatricPal mobile app

[Fluffy Grandma 89]

I was told that once you have your insurance approval, it doesn’t matter. I sweat bullets til my approval. Once that came through I was free to lose some weight.

I have Medicare BCBS. I had my bypass in August and am doing great.

[ProudGrammy 8,322]

On 11/3/2018 at 5:16 PM, El Cee said:

approved for Gastric Bypass - surgery is scheduled for December 3rd

@El Cee

You have been officially approved!! Congrats

talking to your dr about your concerns will make you feel better

re-assurred, that's great! worrying too much will give you gray

hair. I know.😉

good luck next month with your bypass

kathy