When does Insurance look at BMI?

kjl315 · December 1, 2007

I currently have a BMI of 41, so I fit the guidelines for WLS. Aetna requires me to spend 3 months jumping thru hoops, including doctor supervised diet and exercise. Do insurance companies base approval on the BMI at the beginning of the diet/exercise or at the end? If my BMI drops below 40 by the end of the 3 months, will they then say I don't qualify because I followed all their instructions.

Anyone have any experience with this?

Karen

make33 · December 1, 2007

I had a BMI of 41 when I began in March. (5'0 tall / 213#) and my insurance company required six visits to a nutritionist--I too was concerned.

I ended up losing 6# before my surgery date, bringing my BMI down below 39 and had no issues whatsoever getting approval.

Although it seems like a lot of red tape and hoops, please use this time to read everything you can about what your new life will be like--on these threads and any other sites you can find.

By the end of the seven month it took, I was totally ready to give my life over to the Band and its rules. So read, read, read...

Best of luck to you... :girl_hug:

kjl315 · December 1, 2007

I've been researching WLS for several years and stated haunting the message boards months ago. I've mostly been on OH, but when I went for my psych eval, the doctor suggested LBT, so I'vd been on here every day getting as much info as I can. I have my first consult with the surgeon on Tuesday and I'm putting together a list of questions for him.

I just don't want to spend all that time and money trying to satisfy the insurance company if I'm going to end up being self pay.

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Thanks for your help.