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Insurance Declined

hsaffel
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hsaffel    0

hsaffel
Posted

I attended the 6 month lighten up pre-requisite class. Just found out yesterday that my insurance denied the lap band. I want to cry. I have been waiting 6 months for this. They said my BMI is not high enough. It is 39 and must be 40 without complications. I have no weight related health issues but I know if I don't do something about this now, I will start developing problems. My dad had a heart attack followed by quadruple bypass in 2004. He is very overweight and diabetic. WHY did my insurance decline? If I gain 20 pounds that will put my BMI at 40. I want to appeal to my insurance company. Any suggestions? Has anyone had to deal with this? I have Health Net HMO. I will be 40 in December and I wanted to be FAB & 40! I could just cry!!!

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HungryMel    2

HungryMel
Posted

If I were you i'd tell them i was an inch to and inch and a half shorter then you really are (NO ONE MEASURED MY HEIGHT). Talk to your surgeon's office and see what can be done. you maybe have to gain a few lbs. I am sure you can resubmit / appeal this decision...i know that some insurance company's will over 30bmi with co-morib. and 35 + with no co-morib. I am sure it depends on your ins company but you can fight this and see what happens...

I attended the 6 month lighten up pre-requisite class. Just found out yesterday that my insurance denied the lap band. I want to cry. I have been waiting 6 months for this. They said my BMI is not high enough. It is 39 and must be 40 without complications. I have no weight related health issues but I know if I don't do something about this now, I will start developing problems. My dad had a heart attack followed by quadruple bypass in 2004. He is very overweight and diabetic. WHY did my insurance decline? If I gain 20 pounds that will put my BMI at 40. I want to appeal to my insurance company. Any suggestions? Has anyone had to deal with this? I have Health Net HMO. I will be 40 in December and I wanted to be FAB & 40! I could just cry!!!

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Kalipso2    25

Kalipso2
Posted

i agre with Mel... see if your surgeon's office will work with you to either change your height or get re-weighed wearing heavier clothes or ankle/wrist weights. i know, it sounds like cheating (and it is) but you shouldn't be denied just because of 1 BMI point!

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TanyaOwens    0

TanyaOwens
Posted

I have been hearing in the news about the required BMI for Lap Band has gone down by 5 so I would not give up.........look into it. Best of luck!

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      1. LeighaTR

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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