Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BMI Question



Recommended Posts

Last week I had my visit with dr bauman, he said my BMI was 39.4 and that I didn't qualify because it was under 40. Has anyone else had bmi lower than 40, I do have hypertension and it's treated with medicine. Just curious. Actually, I'm looking for encouragement that I will get approved. THe insurance lady felt that it was worth while sending it in to UHC.

Jennifer

Share this post


Link to post
Share on other sites

The FDA specifies two co-morbidities under 40 BMI. Hypertension would count and any kind of back or joint paid would count, as well. Go for it!

Share this post


Link to post
Share on other sites

I was a bmi of 34 and went to self pay in Mexico. There are MANY people here that had their insurance pay with under 40 BMI though. I am sure they will post soon. GOOD LUCK!!!

Share this post


Link to post
Share on other sites

Thanks. My BMI is so, so close. I only need 1 pound to be at a 40 BMI.

I have two herniated disc's in my back and I believe the back dr was going to write an elaborate letter about how weight loss would help,.

Oh, I worry too much. I'm sure everything will work out.

Jen

Share this post


Link to post
Share on other sites

Jennifer - luckily UHC is probably the most friendly when it comes to wls. The chances of you getting approved are great. Get the letter - and as much other info you can from your primary doc - and have that all submitted. Chances are you will be approved - providing there are no exclusions in your policy about weight loss.

Share this post


Link to post
Share on other sites

My BMI was 36 when I started this process. My insurance would pay for it - no questions at 40; or they would pay at 35+ with 2 comorbidities. They are VERY strict about the co-morbidities. They have to be documented and diagnosed by a physician.

For example... hyperlipidemia is a comorbidity - so I had my cholesterol checked. It was 236, which is not normal, but my doc said I did not need meds - so that didn't count.

I am not on ANY other meds... no HBP, no diabetes.

sleep Apnea is a comorbidity (which I don't have) but you need a sleep study to document it.

Osteoarthritis is one, but you have to prove it. I went to an orthopedist and he says my knee pain was not OA= that my XRAYS looked great.

The moral of my story ... self pay.

Good luck!!!

Share this post


Link to post
Share on other sites

Is this your highest weight? If not make sure you have a 5 year weight history from your pcp or gynocologist to help. Even if it is your highest weight I'm betting the weight history would prove that its going up slowly but surely. I mean everyones weights can very a few pounds from day to day. Even from scale to scale. Also get documatation about your back pain from the doctor you saw for that. I don't think you will have a promblem.

Melissa

Share this post


Link to post
Share on other sites

Thanks for all the responces. i haven't given it enough time , but i Keep thinking about the non-40 BMI issue. I cannot seem to shut it off in my head.

I have so much medical documentation from the PCP, I go all the time, luckily, the 5 years coinsides with the delivery of my daughter, otherwise I'd have to get gyn records too. I have ton's of documentation for my back. I am sure my cholestoral is high too. I just cannot get this off my mind. Plus, I have not finished all my paper work and appointments. I have to go to the psych, dietician, and upper gi process.

Oh yeah, to make matters worse, now is open enrollment for my companies health plan, so the insurance offce at dr bauman's said to keep the same coverage because it covers Lap Band 100%. I also have to factor in the fill's.

I'm off....

Jen

Share this post


Link to post
Share on other sites

In that situation I wouldnt hesitate to gain a few pounds. Although its easier said than done when you actually try to do it.

My BMI is 35, and most of the info available on the web is American so I thought I'd have to work hard to prove comorbidities. I woudlnt even consider gaining enough weight to put me over 40 (about 14lb), that would be dangerous, but gee, they'd only have to weigh you after Christmas dinner or something and you'd be there. Its not going to harm you to gain 2 or 3 pounds.

Share this post


Link to post
Share on other sites

I'm acutally 12 ounces from qualifying at a bmi of 40. If I had weighed one pound more I'd be qualified. I haven't heard back from the dr's office.

I'm anxious to know something. I know it's been a short time since I met them.

I'm going for the rest of my testing in Nov. I know it's just a few weeks away.

I;d like to change my insurance next year but there's no way I would while I'm waiting for approval. DH doens't work so he doesn't have any insurance options for us. Also, I am afraid of being turned down.

Jennifer

Share this post


Link to post
Share on other sites

When I did weight watchers....weigh in night was always chinese night. As soon as the meeting was over I'd run by and get chinese takout..lol. It took me almost a week it seemed to get over the amount of sodium that was in that MEAL LOL

Melissa

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×