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

BMI of 37 but no morbidities = no coverage?



Recommended Posts

I have been doing tons of research on the lapband and I have great insurance that will cover 90% of the cost. However, my BMI is only 37 and I have no morbidities. I feel like I'm stuck because I'm not heavy enough and I'm too healthy for all of the extra weight I am carrying.

Has anyone out there been approved without morbidities???

Share this post


Link to post
Share on other sites

Having the same problem.....going with self pay. Not patient enough to fight them or gain more to get the BMI up.

Share this post


Link to post
Share on other sites

Unfortunately, I was the same way. need to lose about 80 lbs. I am going with self pay as well. I have joint pain, but wasnt sure if that would fly or not and didnt want to do the waiting game any longer. I am 44 and need to get this going to start living a new life while I can enjoy it :) Good luck! its a bummer when they say your not heavy enough (how stupid is that)

Share this post


Link to post
Share on other sites

Mine is going to be 9600.00 in denver, colorado. Uggg not looking forward to paying it but I think it so going to be worth it.

Share this post


Link to post
Share on other sites

I'm guessing not... I think you have to be well over that if you don't have co-morbides. My BMI was 46 when I was approved (I was 5'7, 298).. i have no co-morbidies. I tried a few years ago and they wouldn't approve me. I was about 250 then...

I guess they don't see the benefits if it's not going to "cure" something.

Share this post


Link to post
Share on other sites

Mine is going to be 9600.00 in denver, colorado. Uggg not looking forward to paying it but I think it so going to be worth it.

Mine is $11,999.00 w/ a years fills and checkups.

Share this post


Link to post
Share on other sites

My insurance doesnt cover any weight lose surgeries so am self paying also. I'm here in conroe texas and the cost I have is $9,900.00 with a yr fills and check ups.

Share this post


Link to post
Share on other sites

You all really need to call your insurance companys and double check. Just within the past couple of weeks, they are lowering BMI. A couple minutes on the phone beats paying out thousands when it's unnecessary. Good luck! My surgery is 9 days away. YAY!

Share this post


Link to post
Share on other sites

I have to say that my doctor here has been wonderful. Any back, knee or leg pain at all??? Get weighed with your coat on, heavy jewelry, change and keys in your pocket and if you loose an inch, most doctors don't actually take your height- your BMI is higher. Family history of obesity, diabetes, heart attack?? Many different things can be spun to have the insurance company on your side. Best of luck.

We also had a form that we filled out provided by the bariatric surgeon, that showed the different diet, exercise plans that you had tried over the past 7 years-I really think that was a sincher for the insurance. Would love to post it if I could figure out how. If anyone knows how to put an attachement in let me know. Or PM me with your email and I can send it to you directly.

Share this post


Link to post
Share on other sites

I have been doing tons of research on the lapband and I have great insurance that will cover 90% of the cost. However, my BMI is only 37 and I have no morbidities. I feel like I'm stuck because I'm not heavy enough and I'm too healthy for all of the extra weight I am carrying.

Has anyone out there been approved without morbidities???

has your insurance denied you?? the fda recently lowered the bmi requirements to a bmi of 30. (which I think is a little crazy)....I've seen folks in my surgeons office that seriously only look like they need to lose 20 lbs.....

Share this post


Link to post
Share on other sites

I've talked with my insurance and they won't cover me since I don't have hypertension, diabetes, or sleep apnea. Sadly, my parents are both overweight and have all of those things so I see my future in them unless I make this change in my life.

I'm looking at doing self-pay in Mexico since that seems to be an affordable option and is only 2 hours away for me.

Share this post


Link to post
Share on other sites

I agree with whoever above suggested to make a call. You never know. I put off attending my seminar for 6 mo s because I didn't think I'd get approved. Now I'm on my 6 mo diet and well on my way to getting approved. If you are in the houston area, I'd suggest checking out true results.

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

    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 1 reply
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

  • 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

    ×