GSNC 0 Posted February 2, 2009 Hello everyone, I am from NC and I am thoroughly considering the lap band. I have been overweight all of my life, ever since I was born. In high school I really lost control of my weigt and reached 214 lbs. After I graduated I started dieting and exercising and lost around 50 lbs. I stayed around 170 lbs for a couple years(which was my lowest weight since I can remember), then due to several circumstances started to put the weight back on. At the end of 2006 I weighed my heaviest at 250 lbs. Keep in mind I am 23 and 5'6 in height. I started dieting and exercising again and got down to around 220 lbs. Since then I have stayed at that weight and can't seem to budge anymore. I feel like I am on a perpetual diet getting nowhere. I have kept up with the lap band over the past year, in a couple of months I am getting really good insurance through my employer and hopefully might be able to get this. Just wanted to know what you all thought about it, how do you qualify? Even though I am overweight I am a very healthy individual, does that hender me? Do you have to have some kind of illness going along with being overweight for your insurance to cover the procedure? All advice is welcome! Thanks. Mary Share this post Link to post Share on other sites
kiz 1 Posted February 2, 2009 Hi Mary. Insurance company's requirements are all different, but if your BMI is less than 40 but greater than 35, you may qualify for coverage if you have other conditions, such as diabetes, high blood pressure, sleep apnea etc. I didn't have WLS coverage on my insurance policy, so I'm not familiar with all the comorbidities that might be included. I think some policies require one ailment, while others may require two. You'll have to check with your policy to get the details, since they're all different. Share this post Link to post Share on other sites
TQUAD64 9 Posted February 2, 2009 Mary: There are different ways a doctor can qualify a patient for the surgery. 1. The patient has a BMI of 40 or higher or 2. The patient has a BMI between 35-40, with medical issues. Every insurance plan is different and is based on what your employer purchased for its employees. Some employers don't cover WLS via the insurance plan, while other employers allow WLS. You will not know what to do next until you know what your employer insurance plan covers. Call the insurance company and make an inquiry. If they cover WLS or if they do not, ask for the policy in writing. Good luck! Share this post Link to post Share on other sites