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

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

    • 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. 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.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 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

    ×