Almost giving up. Have not had a BMI of 40 for 5 years only 3 :(

[jessicakolman 3]

I've been wanting to have the lapband surgery for while now. I have a BMI of 40 and have had that for about 3 years now. I believe with Blue Cross Blue Shield they require a BMI of 40 for the past 5 years or 35 with a qualifying condition like BP issues, which I don't have.

I just realizaed that even 3/12 years ago I was barely a BMI of 35 so I'm worried I won't qualify.

I can't wait another 2 years to have this surgery. I'm too tired of being fat.

I feel so desperate to the point I may starve myself somewhat to lose this weight.

I don't know what to do.

[GratefulHeart 0]

Greetings! The first thing to do is be sure you know what your insurance will or will not cover before despair. It's so much easier to handle when you know what the obstacles are, rather than reacting already to what they might be. For example, on the five-year thing, I thought I understood that it was five years struggling with weight with little to no success, not five years with a BMI of 40. Some insurance companies (like mine) don't require more evidence if you have a BMI of 40, regardless of how long you've had it there. Others require more evidence if your BMI is below 40. So - try not to despair - find out first what your insurance companies covers and go from there.

I have not yet been banded, but heard that my insurance will cover 70% of the cost because my surgeon is out of network; but they will cover it. After they found my BMI to be something like 41, there were no further questions. I'm still in the stage of getting all the labs and pre-work done. But my husband is in favor of it, my MOM is in favor of it (hurray!), my sister is in favor of it, and it appears that the doors are opening slowly, even though I'm not sure what I'll find when I get there. But keep on trudging forth until you get to an obstacle, then figure out what to do to get past it.

Keep us posted!

[StephanieE 0]

I have BCBS and they only required a BMI of 40 or greater for 3 years. You should call them. Just so you know I had to fight for them to pay for my band. But, I was banded May19th 2008 and they paid for 90% of it. So don't give up yet!! Good Luck.

[tas 0]

Call the 1-800 number on the back of your Insurance card and ask if Procedure code 43770 (lapband) is a covered procedure. If so, tell them to mail you a copy of the policy pertaining to the requirements for it and you will then have a hard copy for future reference. That's the best way...

[Melisa1 0]

Hi guys...i dont know if im in the right place to ask this question but...I have UHC ppo. They cover 90% for bariatric surgery. Ive done all my testing. sleep study, ekg, blood, urin, chest xray and endoscopy. Then "today" my surgeons office tells me that i have to have a five year history of having a bmi over 40 or two co morbidities. First of all...why didnt they tell me this at the beginning? and second is this stated in my policy? they flat out told me all of a sudden that it wont be approved by my insurance? This is such a slap in the face. Ive been over weight all my life, my bmi is 40 and i weigh 230 lbs. 5'3". Yes my weight has dropped 5-10 lbs up and down forever but COME ON. thats rediculous! Does anyone have any recommendations or ideas, answers, hope??

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Melisa:thumbup: