Bmi 37?

[kiddobiddo 0]

Hi. I was just wondering if anybody knows if I should qualify for the lapband surgery with a BMI of 37? I have sleep apnea, high cholesterol and GERD. I know it depends on my insurance company, but I have already received a referral to lapband surgeon from my pcp and have "started the process"....am waiting for my psych consult then nutrional consult before the surgeon's office sends for surgery approval. I am just wondering if anybody has gone through all of this and been denied? I know it's not a waist of time to try,...but I don't wanna get myself psyched up for the surgery if it looks like its not gonna happen? Anyone know qualifications? Thanks....bye

[luluc 6]

. I am just wondering if anybody has gone through all of this and been denied?

i had a bmi of 36 and was denied.

my insurance required for those w/a bmi under 40 have 2 comorbidities - which i did not have. i went self pay.

good luck to you!

[kiddobiddo 0]

Thanks ...do you happen to remember what the co-morbities were considered?

[luluc 6]

Thanks ...do you happen to remember what the co-morbities were considered?

they had to be significant.

i have arthritis and that wasn't even a consideration.

my husband was banded w/me and he too was denied (under 40 bmi) with high blood pressure * sleep apnea.

i would call your insurance company and get a copy of the policy as it pertains to weight loss surgery. in my opinion, if they can get away not paying for the surgery - they will..

btw - i had blue cross. we switched insurances at my husband's next open enrollment and now have UHC & they cover everything band related even though we went self pay.

[kiddobiddo 0]

Wow...you have done great!!!! Looks like it was totally worth your money, unfortunately you had to pay. I will find out around JUne if I get covered or not (after my pscyh consult, the surgeon's office submits for authorization on surgery)...who knows...the insurance company may want me to gain 9 pounds..yeah that makes a lot of sense...well thanks for your time...and a size 6 is way good!!!!!!!!!

[ParrotheadCathy 0]

You say you have "sleep apnea, high cholesterol and GERD". sleep apnea is definitely a co-morbidity. Not sure about high cholesterol. GERD is not. Co-morbidities include high blood pressure, Type II Diabetes, and sleep apnea. Like I said, not so sure about the cholesterol issue.

[kiddobiddo 0]

Thanks Parrothead...and congrats on your surgery. Yes, I am hoping sleep apnea along with my obesity bmi 37 is what my insurance company is looking for....i think some insurance companies only require one comorbity while others two...i guess i'll have to wait to see

[gamyj 0]

high cholestrol was concidered one. I was told u have to have a bmi of at least 35 or was it 36 with at least 2 comorbidities. I also think my reflux was concidered a comorbibidy.

good luck,

amy

[Shauna80 0]

I had a BMI of 36 and I had PCOS and high blood pressure. I only had 80 pounds to lose and Im down 45...35 to go!! Its worth the fight. I have BCBS and they covered everything, but it really depends on the coverage of your employer. Good luck!