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

Daisy1244

By Daisy1244, in Insurance & Financing

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Daisy1244    36

Daisy1244
Posted

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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SusieSunshine    68

SusieSunshine
Posted

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?

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Jackie Murphy    10

Jackie Murphy
Posted

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!!

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lika92012    9

lika92012
Posted

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)

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Daisy1244    36

Daisy1244
Posted

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.

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SusieSunshine    68

SusieSunshine
Posted

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.

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SusieSunshine    68

SusieSunshine
Posted

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

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kmartinez973    46

kmartinez973
Posted

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

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Karie1275    12

Karie1275
Posted

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.

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secondchancesally    43

secondchancesally
Posted

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

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Daisy1244    36

Daisy1244
Posted

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

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Joy1961    134

Joy1961
Posted

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

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radarluv    59

radarluv
Posted

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

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Daisy1244    36

Daisy1244
Posted

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

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Anch    52

Anch
Posted

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

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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

      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

        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.

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