cyndilou29

When you guys went through it, was it your initial weight that they looked at or the weight just prior to surgery. I am literally at a BMI of 40 right now. 1 more pound loss and I don't qualify.

I'd like to know myself. I know we can't do collagen implants and such. Wonder if this would even be okay. Didn't bring it up to my neurologist but I will now!

I am going to have to do this self pay and I've seen quite a few of you had the surgery there. I have to tell you - I'm terrified of doing that. It scares me to death but I would like to have some information from you and your experiences if you don't mind sharing.

I know many of you had to go through many appeals to get this done. I have been told by my insurance that my employer excluded it from coverage. My question is this: what happens if I lose some weight in the interim? My highest was 241, currently 231 but what happens if I lose, say 20-30 lbs and my BMI is no longer over 40? Do I not qualify if I win the appeal now? I am not well and cannot stay at this weight (pre-diabetic, high cholesterol, GERD, sleep apnea, multiple sclerosis) but I don't want to eliminate myself from this surgery altogether. I am at at BMI of 40.2 right now. Why is this so hard? When will people understand this is a health issue and not a "character" issue?

We just switched to Highmark January 1. Do you know if it is the employer who makes the final decision on what gets covered if you are on a self funded plan? ie does the appeal go to them ultimately?