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Low Bmi ....insurance Approval ....anyone In The Same Boat?

Hi,

I have a BMI of 35.6 the doctor basically said not to lose any weight until approval. I have blue cross blue shield direct access. I do not have high bp,diabetes, sleep apnea. I do have high cholestrol and osteo arthritis. Did anyone who has a low BMI with no major health issues have any problems getting approved? The doctor does not want me to go to a lower BMI for now in case the insurance does not approve it. Any one else similar to this situation? I live in the beautiful state of NJ

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I have a bmi of 37. 3 comorbids. I don't believe they will re weigh you. I got approved. Did you call your insurance do ask what their criteria are?

I too was 35.4 with HBP and High cholestol...and BCBS of MN approved me! During the 6 month PCP and nutritionist visits i managed to lose 6 lbs in the 1st 3 months and then the next 3 months let the 6 lbs creep back on. I too was afraid if i feel under the 35 BMI i wouldn't get approved! I hate to say it but it was teh worst 6 months of my life (and my husband would agree)! I have been banded since the begining of July and it has sense been great! I am down about 30lbs including the 2 weeks of pre-op liquids!! Hang in there!!! it will happen!!

I was 35.1 and surgeon told not to lose a pound until final weight in.My surgery tomorrow and just yesterday i got approved. I have high cholesterol mild sleep apnea and hbp(nothing major)

  • Author

I'm afraid to call insurance company because I think they might red flag me if I ask to many questions. But as I'm am trying not to lose weight I'm stressing and I'm gaining. Feeling just terrible.

Just call and ask. Tell them u want to remain anonymous! It will put your mind at ease. I hate to say this because people will bring up insurance fraud but there is always ankle weights. I know they use the original consult weight. Then won't change the coverage if lose after approval before surgery.

Oh I also told them I was an inch shorter. They never checked.

Daisy I am also in jersey...what area are u from and what hospital...I am having mine done at st Barnabas...dr nussbaum

I'm affraid I'm going to get denied because I have Medicaid. I've tried looking up their requirements but still can go either way. My bmi 63.2 and I have hypertension and high cholesterol. I'm so nervous and worried they will turn me away.

I have a BMI of 32 and I was told by my Dr that I didn't have a chance despite my arthritis and a back problem that necessitates me losing weight. Unfortunately I think that the 35 BMI cut off is pretty strict. I considered slumping, packing on a few extra pounds, but the truth is, I would have a big way to go to qualify because I'd have to gain a lot of weight PLUS my comorbids are not the ones that "impress" the insurance companies. Shame because back surgeries, spinal injections and pain management aint cheap either, you would think my insurance would want me skinny before the S%#& hits the fan medically

  • Author

I'm live in toms river, dr reich is my surgeon. He must be popular alot of people use him.

Hi' date='

I have a BMI of 35.6 the doctor basically said not to lose any weight until approval. I have blue cross blue shield direct access. I do not have high bp,diabetes, sleep apnea. I do have high cholestrol and osteo arthritis. Did anyone who has a low BMI with no major health issues have any problems getting approved? The doctor does not want me to go to a lower BMI for now in case the insurance does not approve it. Any one else similar to this situation? I live in the beautiful state of NJ[/quote']

Hi i have almost the same stats as you and i live in Nj. Also have BC BS. I dont have any ins issues. Just finished all tests. Hope yo get a date fri when i go in for follow up if endoscopy. Good Luck! PS. Where in NJ? Im in Sussex County

I had a Bmi of 35.5, but I had 2 co-morbids-hypertension and diabetes. 3 really, but insurance does not count high cholesterol. Seriously doubt you will be approved without at least 1, but stranger things have happened. Good luck.

Hi,

I have a BMI of 35.6 the doctor basically said not to lose any weight until approval. I have blue cross blue shield direct access. I do not have high bp,diabetes, sleep apnea. I do have high cholestrol and osteo arthritis. Did anyone who has a low BMI with no major health issues have any problems getting approved? The doctor does not want me to go to a lower BMI for now in case the insurance does not approve it. Any one else similar to this situation? I live in the beautiful state of NJ

  • Author

I go for a sleep apnea test on Sat. All my test will be complete at that time. Tell me if you get approved I'll be interested to know. I am in ocean county....toms river

I have a BMI of 37.5 with high cholesterol and now I am waiting for approval... My insurance is Empire BCBS.

I'm in ocean county too. Jackson area. I have aetna and they denied my sleep study. What r the chances of getting approved for the lapband? Getting very discouraged.

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