BMI between 35-40??

[jen083102 0]

Hi everyone!

I have just started looking into getting the lap-band procedure. After calculating my BMI, I am just over 38. I was wondering if anyone else who has been between a BMI of 35-40 has had their surgery approved thru insurance without having any co-morbidities? I was calculating the difference, if I weighed about 12 pounds more I would be at a BMI of 40....almost seems a little silly....should I gain 12 pounds so I can get the assistance I believe I need to live a healthly life or does your insurance company take this into account? I know each insurance company and case will be different...just wondering what others experiences have been.

Thank you! :thumbup:

[TSB 1]

Hi everyone!

I have just started looking into getting the lap-band procedure. After calculating my BMI, I am just over 38. I was wondering if anyone else who has been between a BMI of 35-40 has had their surgery approved thru insurance without having any co-morbidities? I was calculating the difference, if I weighed about 12 pounds more I would be at a BMI of 40....almost seems a little silly....should I gain 12 pounds so I can get the assistance I believe I need to live a healthly life or does your insurance company take this into account? I know each insurance company and case will be different...just wondering what others experiences have been.

Thank you!

I was approved by my insurance w/ a BMI under 40. But I take lipitor for high cholesterol, so that counted as a co-morbidity. Have you reviewed your insurance policy to find out what they consider to be a qualifying co-morbidity?

[ParrotheadCathy 0]

Jen, be aware that your insurance company may require that your BMI has been at 40 for a specific period of time (my girlfriend's policy said hers had to be 37 for 3 years to be covered even WITH 3 comorbidities).

The only way you'll know is to talk to your insurance company. Ask all the pertinent questions.

Tell them your BMI and ask if you can get coverage. If not, if you continue to gain (as most of us eventually would), would they cover you at 40 or do you have to have that BMI or higher for a specific period of time?

Go ahead and ask if you have to use a Center of Excellence, names of doctors on your plans, surgical centers on your plan and other requirements (like psych eval, pre-op diet, sleep study, etc.)

[bluetopaz 0]

Hi, my BMI was 39 and my weight 200 but I had 4 co-morbidities so I qualified.

[MrgrtVntll 0]

Hello Jenn

When I started out my BMI was at 38.4. My doctor told me it was iffy with my insurance. I have BCBS HMO of MA. I do not have any other comorbities. My insurance wants one if my BMI is under 40. Needless to say I was disappointed. I told my doctor if I have to gain 10 pounds to loose a 100 I would. He laughed at me and told me not to do that. However, knowing how much I want to have the LB tool I have been eating more than usually. All my eating in the last three weeks have gained me only 4 freakin pounds (BMI now 39.1). I DO NOT recommend anyone trying to gain weight...I feel like crap and tired all the time. I have been overweight most of my life and have been on medically supervised diets (that worked slightly). Basically what I am trying to say is do not gain weight...hopefully your Doctor's office will be able to help out in getting you approved. I am half way through my appointments and I am stressed out beyond belief. I cannot wait until after tonight's visit with my nutritionist. I am tired of eating...just to gain insurance approval. I know I will have the surgery one way or another. Good luck to you and I hope things work out!

Peg

Edited September 2, 2009 by MrgrtVntll