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Insurance Approval

nicolemm

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nicolemm    24

nicolemm
Posted

So as I've been going through all my appointments it's been concluded that I have no co-morbidities to go along with my high BMI. Normal blood pressure, good cholesterol, I am able to excersize and no sleep apnea. All in all this is good health wise. BUT I am so nervous my insurance wont approve bc of this. my BMI is 45 which is very high.

did anyone have trouble getting approved with no co-morbidities? My dr says I should be approved because of the bmi alone but as we've all probably found out along the way, nothing is guaranteed.

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nursesweetc    25

nursesweetc
Posted

I am the same way. High Bmi but healthy as a horse. No problems getting approved. Oct 8 th is my band day....

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nicolemm    24

nicolemm
Posted

That's good to hear! What type of insurance? I have Cigna. Dr will submit my paperwork after my last appointment on the 15th.

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Lesley714    4

Lesley714
Posted

I also have cigna with no co-morbidilies. I don't have high blood pressure or diabetes but my BMI is 55.4. Today was my one on one with my nutristionist and I asked him if I would have a hard time getting approved. He said no because my BMI is extremely high and im 100 pounds over weight.

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Ashygurl    0

Ashygurl
Posted

Hi everyone! I am going to my initial dr appointment with my doctor on Friday. How long was the process for you from start to op day? I also have Cigna and am nervous about approval though. I was a college athlete until 2005 and then I had reconstructive knee surgery and ankle surgery after injuries from my sport. My BMI is now 41, and I hope the lap band is an option for me.

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nicolemm    24

nicolemm
Posted

With Cigna it's taken me about 3 months with my final appointment on October 15. Cigna likes to see a three month waiting period according to my doctor and the woman at his office that deals with insurance.

So far I've had my initial appointment, an upper GI test, an appointment with the nutritionist (today is my second appointment with her), an appointment with a pulmonologist to discuss apnea, an appointment with my surgeons APRN, a sleep study and a psych appointment.

It's taken me about 2.5 months to do all those appointments and they are going to submit my paperwork to insurance after my appointment I the 15th.

It's been a lot but I know it'll be worth it! Good luck!

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • KeeWee

      KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
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      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.

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