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Dont know if my BMI is high enough



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I'm 5'6 weigh 215 lbs but my BMI is 35 all I keep reading is 40 and above and they will consider the surg I have been over 200 lbs for well over 10 years. Sick and tired of being fat!

also what is this documentation of a dr supervised diet history? I havent seen my GP for over 6 years (I Know) What kind of documentation are they looking for?:thumbup:

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Hello! It all depends on what type of insurance you have. When I was approved, I think I weighed between 219 and 225 pounds and I'm 5'5.5" so my BMI was "only" like 36 or 37. My insurance required BMI of 40 or more OR BMI 35 or higher with 2 comorbidities. I have PCOS as well as sleep apnea, but I went through a sleep study to document it for insurance. I also had to turn in my past 2 years of medical records, as well as do a 6 month diet.

The best thing to do is to call your insurance company yourself and find out exactly what their requirements are. Also, if you've already decided on a surgeon, many offices have an insurance specialist that are very good at this too.

Good luck!

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Hi, I just went to the doctor today and he said we could try to get insurance approval but he didn't seem optimistic.

I'm 5'3" and 210 lbs and my BMI was 37. I have United Health Care for insurance and the coordinator said they're a tough company. She told me go to my doctor/s and get a 5 year documentation or the weight gain.

From what I read on many websites the comorbidities that I had were depression and high cholesterol but I guess they're not that serious because the doctor told me if I had high blood pressure or diabetes I'd get approved with that BMI.

This is very frustrating.

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I am 5'5" and when I went to the surgeon for the first visit I weighed 201 so my BMI was 33. My highest weight had been 210 about a month before when I saw my GP who suggested I see the surgeon.

My GP sent in the weight history of 210 and the surgeon sent in the 201.

I do have sleep apnea, high blood pressure, neuropathy from past chemo, and a few other problems that hopefully will be relieved with weight loss.

I have Anthem BC/BS which from what I hear is one of the best for approvals. I was approved in less than 2 weeks.

However I still had all the meetings with the nutritionist and psychologist, and x-rays etc.. before I could schedule the surgery so even though I was approved in July my band date is 9/18, less than 2 weeks!

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Every insurance company is different. Mine already had proof of me trying to diet by going through the doctor supervised Optifast program last year. I actually ended up eating to gain 25 lbs to qualify for the surgery. I was 40.5 BMI when I went to the surgeon and they submitted it to the insurance company immediately. I was approved and now I'm going through the testing. My last test is the sleep study which I have scheduled for the 10th and then I can schedule my surgery.

Contact your insurance company and see what they say. My mother always said if they decline you always submit an appeal.

Good luck!

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I was approved with a BMI of 36. I had joint issues and back problems so it is a varied degree of things that can get you approved. Good luck I hope you dream comes true I know mine did. I Luv My Band!

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