Low BMI and Insurance

[Doublewall 0]

Hi all I have a question for you and would greatly apprecaite it if you could help me out. I want to get the lap band am doing the 3 month supervised diet for my insurance Aatna. I have a low BMI of 37 but was told I could probably get aproval since I have a Psuto Tumor Carebri and have to lose weight or I will loose my eye site (it's complicated I know) My question is has anyone else been approved for the surgery because of this condition? I am getting a little concerned after I reading the insurance blogs. I have been going to Emory for my Dr. supervised diet and will finish my 3 months around the middle of Oct. I have already lost the 10lbs. I need to loose and hope I can keep it off before I see the actual surgery. Anyway if anyone has any advice or words of incouragement that would be great. Thank you so much.

[PATCHELTON 0]

I do not have your condition, but my insurance said with a BMI 35-40 you had to have one or more co-morbidity (condition that is affected by weight--diabetes, high blood pressure, high cholesterol, sleep apnea, GERD, joint arthritis--I had all but diabetes). My BMI was 37-38 and I was approved. Your condition might be out of the ordinary, and you may need some support letters from your eye doctor/primary care doctor explaining how this is related to your weight. I certainly think that should work. You never know with insurance companies, but the more documentation you can get, the better. Good luck. BTW I have Blue Choice Insurance.

[Doublewall 0]

Great thank you so much for responding back I will definantly give it a try.

[hallen651 8]

Hello my name is Holly and my BMI is 36.8 I have Cigna OAP,I HAVE GERD,ARTHRITIS,HIGH TRIGLYESERIDES,SEVERE BACKPAIN,AND BORDERLINE DIABETIC:cursing: I was wondering if you've heard of anyone getting the band done with a low Bmi like mine and info would be helpful.

[Doublewall 0]

Hey Hellen 361 I have read of a few people on this web site that have had low bmi's and getting approved but I don't remember where it was on this web site sorry but good luck I hope you get some replies. It sounds like you have a good case though so maybe you will get approved have you started your visits to the Dr. for the surgery or anything like that yet?

[hallen651 8]

Hello thanks for the reply Yes I only have 2 more months visits with my pcp and I have everything else done.How about you have you had the band?

[Doublewall 0]

Hey Hellen I have not had the surgery yet but like you I am in my second month of supervised diet.I have had mu psyc. done (that was pretty interesting) and I go to the nutrisionalist as well.I have not seen the l surgeon yet was told I had to do the 3 month thing first. Any good luck and keep me informed on how things are going with you and I will do the same.:thumbup:

[hallen651 8]

Well i'm so glad we are in this journey together are you going to be self pay or insurance?I have Cigna OAP and i have heard they are very hard to deal with.My surgeon said I have a good chance on getting approved due to my co-morbid issues.Well keep me posted and ill do the same.

Thanks Holly

[Doublewall 0]

I hope I can get my insurance to pay (aatna) but we will see if they don't I won't be able to do it. But I think I have a good chance since I have a Pseutotumor Cerebri. What about you are you self pay or insurance. I hope to find a good surgeon in Atlanta.

[hallen651 8]

Well I have Cigna OPA insurance and if they dont approve I wont be able to have it done either but im hoping and praying.My surgeon is DR Ali at HAMOT MEDICAL in Erie PA.He is wonderful aswell as the staff.I only have 2 more months of recorded weight loss with my pcp and 2 more support meetings to attend and they will be sending in all my info to the insurance.Then is the waiting and praying game wish me luck:confused_smile:

[Doublewall 0]

I sure hope it all works out for you I know exactly how you feel. I can;t believe you already got to see your surgeon they told me I could'nt see him until I finish my three month plan i also had to loose 10 lbs. and i am happy to report as of today i have lost the 10 now I just have to keep it off untill I get approved. How was your visit to the surgeon? Was he nice?

[hallen651 8]

Wow 10lbs thats awesome!My doctor is great he likes to meet with you first just to see what surgery would be best and also for insurance reasons I have to have 6months diet with pcp and phyc eval,upper gi,pulmonary,3support meetings and 2nutrition appts befor I can even send info over to have ins approval.If you dont mind me asking what is Pseutotumer Cerebri?

[Doublewall 0]

OMG your list sounds long of all the things you have to do I hope they don't spring that upper GI thing on me I don't know much about that procedure does it hurt to have it done? Well a Pseutotumor Cerebi is a condition that affects mostley women that are of chilbearing age and are over weight. It is not a real tumor but it feels like you have a tumor in your head all the symptoms are pretty much the same as having a real tumor. I have alot of migrains and my vision blacks out like when I stand from sitting or when I get out of bed in the morning and I get this sound in my ears like a heart beat alot and this is really weird and hard to explain but I hear this sound when I turn my head like Fluid rushing from my spine at my neck. I also have alot of pressure behind my eyes and have a blind spot in my field of vision that they found during my vision test. They said it was'nt permanent but it could be if I don't loose weight I have noticed that when I do loos weight the symptoms get a little better but I really think I need to loose alot of weight for it to feel completely better. I also suffer from memory loss and I am tired alot and I also have to pop my ears alot to take the pressure off my ears like when you go up in the mountains and have to pop your ears. I know all of this sounds weird and I have to say I only felt like I needed glasses when all of this started and as I have gained weight and as time has went by I started feeling all the other symptoms. When they told me I had this I had never heard of it and had to look it up on the internet. My Dr. told me not to go look up a bunch of sruff because it would scare me and he was right so I only stuck to the sites he told me about. Anyway I hope all this has'nt been too much info ro too confusing.LOL :thumbup: