BMI & weight loss before surgery

[hollywrites2u 15]

Hi all, I'm wondering if anyone has some insight into losing weight before surgery and your BMI being too low to qualify.

My BMI is 39.9. The doctor would like me to lose 10-15 lbs. That would bring my BMI down to about 37. I don't have any other medical conditions (High blood pressure, diabetes, sleep apnea). It seems like 40 BMI or higher is required to be approved by most insurers.

Has anyone else run into this situation? My BMI was 50 when I had WLS 20 years ago so losing the pre-surgery 15 wasn't an issue.

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[lizonaplane 1,612]

I would ask your surgeon why they want you to lose weight given that your BMI is below the cutoff for most insurance, and tell them your concerns. Many doctors don't think much about costs for patients.

Talk also to the insurance coordinator at the surgery center and ask their opinion. They aren't a medical person, but they deal with getting insurance approval.

Do you know if your insurance will cover surgery if your BMI is 40 or higher? If you are self-pay anyway, it's not a bad idea to lose weight because the lower your weight, the easier the surgery is on your body.

[hollywrites2u 15]

I would ask your surgeon why they want you to lose weight given that your BMI is below the cutoff for most insurance, and tell them your concerns. Many doctors don't think much about costs for patients.
Talk also to the insurance coordinator at the surgery center and ask their opinion. They aren't a medical person, but they deal with getting insurance approval.
Do you know if your insurance will cover surgery if your BMI is 40 or higher? If you are self-pay anyway, it's not a bad idea to lose weight because the lower your weight, the easier the surgery is on your body.

Thanks for the reply, Liz. I can't do self pay with my current financials. I didn't even think about it but it's a lapband removal so BMI likely doesn't matter. I want to get a gastric bypass but that's down the road. My approval isn't 100% locked down. The insurance coordinator is contacting my insurance companies. She said they've received approval for my insurance even though the HR dept. at work said they don't cover bariatrics.

The surgeon said if my insurance tries to wiggle out from paying then I may well end up in the emergency room and he would do the surgery there & it will cost them even more. [emoji44] [emoji848]

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