Hi everyone, I am scheduled to see a surgeon June 28. I have done a lot of research and I am certain this is the best option for me, the only thing I am unsure of is that my bmi is just at 40 if I lose a couple pounds it will be under, my insurance is bcbs ma hmo blue.I have been lurking on this site and it seems I have read a lot of insurance horror stories. I have no comorbidities other than knee pain, but that is because I am somewhat young, 37. I have tried all types of diets and lost, but regained and then some! I guess my question is if I am starting out at a bmi of barely 40 and get the nutritional counseling, etc to show I am capable of losing, if in the process of following the program. lose a couple pounds, in order to qualify will I disqualify myself??? I know that sounds nuts, but I keep wondering if they use your starting bmi or what? Just wish i knew so i could sleep! Thanks, Kristin:notagree

Hi Kristin,

I also have BCBS of MA. I don't know what hospital or clinic you are going too but I go to Lahey clinic in Burlington. This is how it worked for me. I had 39.8 BMI and weighed in at 236. What happened to me was the clinic uses my first weigh in as my weight that the insurance company gets. Then I was giving a number of pounds that I needed to lose to get the WLS, so the liver would shrink and what not. So you should be okay. It would not reflect your starting numbers. Not all, but most Dr.'s ask you to lose a few pounds before the surgery. Mostly to help shrink the liver, some do it to see that you have made the commitment. That is just my experience. I'm sure others may have other thoughts on this.

Good luck, if you're looking for a buddy to chat with, I'm here for you.

They usually use your starting weight when submitting to the insurance. Is the nutritional counseling you mentioned part of the surgeon's program or is it something required by your insurance?

One thing to remember is that the surgeon's office / clinic, assuming they specialize in weight loss surgery, *wants* you to have the surgery. They make money from it and from the followup fills. So they will be working with you to get you qualified for the surgery. And they may know the ins and outs of working with your particular insurance company, too, if the surgery center handles any of that for you. (mine did all that paperwork for me)

Your Dr. will only submit it to the ins. company once and The weight they recorded on your first visit is the one the ins. knows. If you lose after this that is great. I was the exact same I had a BMI of 40 (bairly) with no comortalities, but now Im at a 39. Good luck...

I was at a 38 for BMI and I was told not to lose too much but not gain anything. My ins approved me, no problem. I did end up gaining some but lost 9lbs then gained again, lol. Then I had my surgery and have been losing ever since. Good luck to you.

Hi, my BMI was 40 and they took the BMI only on my first appointment for surgery. They then weighed me, at the hospital, the day OF the surgery. I wouldn't worry too much about that part. You can be successful at BMI 40. I have 75-100 lbs to lose so good luck to you as well!