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Trying To Get Approved For Lapband Surgery

Did anybody have any issues with getting approved the first time?

  • Replies 9
  • Views 997
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Many do. So many variables can disqualify your application. But, if your plan does provide coverage of WLS you should qualify unless your BMI is under 35 with no co-morbids.

tmf

  • Author

My BMI is no where under 35....I didn't know if it made a difference or not cause I don't have any pre-existing conditions like high BP, diabetes, etc....

Every insurance company is different. Some make you go on 3,6 or 12 month diets. My insurance allowed me the surgery based on my bmi

  • 2 weeks later...

It varies from company to company. I would recommend you get a copy of your insurance policy and see if bariatic surgery is covered and if it is find out the guidelines for getting it approved. If it covered I would work with my primary doctor to get a referral to a bariatic surgeron. That's the steps I took to get my approval.

  • 2 months later...
My BMI is no where under 35....I didn't know if it made a difference or not cause I don't have any pre-existing conditions like high BP' date=' diabetes, etc....[/quote']

Mine was 34 & I got approved with a powerful appeal letter.

  • 2 weeks later...

I had to do tons of pre op tests like sleep studies, upper GI and even my gallbladder out. After that my insurgence said they wanted 6 month supervised diet. THEN after that my insurance denied me. My BMI was a 52 and then still denied. Luckily I have a great bariatric center and they appealed it and FINALLY I got approved as medically necessary and 3 days later got banded.

It's different for everybody but definitely look into what your insurance covers . Good luck

  • 1 month later...

My procedure was approved in 7 days. I have Tricare Prime. GOOD LUCK.

Kaiser Permanente--sleep study, psych eval, morbidly obese (BMI in 40s), two comorbidities (pre-diabetic, sleep apnea), PCP referral--took about four months for approval and had to pay 50% of the cost of surgery myself. Good luck!

My procedure was approved in 7 days. I have Tricare Prime. GOOD LUCK.

This makes me so happy to hear! I have Tricare Standard and was hoping that I could get approved before my husband deploys!

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