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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'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.

I have Aetna and live in NJ. Please refer to Aetna or your insurance carriers specific policy regarding bariatric surgery. Aetna is policy 157. It is very strict. You can find it on their website. BMI has to be 35 with comorbidities. I have been denied for hypertension because it has to be uncontrolled and require 3 different meds! Wow.

Sooo discouraged.

  • 2 weeks later...

Update! My surgeon and primary physician went to "peer review" with Aetna's medical director and won! The secretary in the office told me that Aetna denies some 40% of patients. Keep your head up! I am sheduled wed Oct 10.

Congratulations!! Best of luck to you. I have my final appointment tomorrow and then it goes in for approval with Aetna. Fingers crossed!!

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Don't know how it happened but I got approved and I have the letter to prove it!!!! Yea!!!

So happy for you Daisy1244!!

My BMI is 37.59 I have United Healthcare with no medical issues, I'm very borderline!

If one doesn't have insurance... How much is this surgery?? I live in Syracuse, NY

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