Soooo, I got denied for my insurance because basically, Im fat, but not fat enough and Im "too" healthy. I have a BMI of 38 and at the time of my weigh in weighed 248lbs and my height was at 5'7 1/2 (i slouched a little lol) and I am NOW (about a month later) weighing in at 253lbs but it hasnt been documented. My insurance is (empire BCBS) telling me that I either need to have a BMI of 41 or higher or I need to have a co-morbidity with my current BMI and I dont. Im very healthy, Im just fat. But apparently not fat enough.

So i guess my question is, would it be ethical to gain 12-15 more pounds just to get this insurance approval? Because when push comes to shove, without it, Im not getting this surgery. I just cant.

So any advice on how to gain a quick 12 to 15lbs? or advice on what to do at all?

Thanks

<3

Caitlyn

Soooo, should I just call my insurance and beg?? lol I dont know how to write an appeal letter for this type of rejection... Im not sure how to convince them that it IS medically necessary... Any ideas or templates? lol

Soooo, I got denied for my insurance because basically, Im fat, but not fat enough and Im "too" healthy. I have a BMI of 38 and at the time of my weigh in weighed 248lbs and my height was at 5'7 1/2 (i slouched a little lol) and I am NOW (about a month later) weighing in at 253lbs but it hasnt been documented. My insurance is (empire BCBS) telling me that I either need to have a BMI of 41 or higher or I need to have a co-morbidity with my current BMI and I dont. Im very healthy, Im just fat. But apparently not fat enough.

So i guess my question is, would it be ethical to gain 12-15 more pounds just to get this insurance approval? Because when push comes to shove, without it, Im not getting this surgery. I just cant.

So any advice on how to gain a quick 12 to 15lbs? or advice on what to do at all?

Thanks

<3

Caitlyn

I have heard of people wearing ankle wieghts and stuffing their bras and underwear with heavy bean bags.

Load up on carbs!!! I have also hear of people wearing ankle weights to the doctors office. Don't give up though!!! Sending positive thoughts your way!

lol you guys are funny. I might just do it!

I've actually heard of some people sewing weights into the inside of their pants...kinda like heavy fishing weights. I'd say try to find some thin ankle weights and go for it!!

I was in the same boat as you...fat but not fat enough but too healthy. BMI was 37. I ended up going self-pay to Mexico. I don't regret my decision at all...I got to have my surgery when it worked well with my job because I could pick my own date instead of having to wait for a surgeon to fit me in.

I have heard of people wearing ankle wieghts and stuffing their bras and underwear with heavy bean bags.

That is hilarious and brilliant at the same time! They might notice some ankle weights, but they sure as heck better not be snooping around your bra!!

The only problem is that my last appointment where i weighed in at 248 was 6 weeks ago. In order to become a BMI of 41 I have to weight 270. It would be hard for even me, to gain 22 pounds in 6 weeks... I dont want them to get suspicious...lol

Maybe you are losing calcium, or you might have thyroid deficiencies. I would not gain weight, but just show documents where you have tried to lose weight with diet, exercise and general calorie counting to no avail. Check your bones out and joints because you may have probs with your knees and low back. I would also do pulmonary tests to see if you have asthma--I got diagnosed with it last winter before I got surgery.

This shows you should check your BMI before you go & gain weight to stay above BMI of 40. Some Insurance company's do not see the long term money saved by using this as a prevention operation. Some Insurance company's see it & do not make you jump through hoops to get it paid for.

Good luck to you.

Before I decided to get the sleeve a co-worker went throught the whole process and was denied by our insurance. Then she would eat large meals for dinner: cheesesteaks, mac and cheese, etc and then lay down and watch tv and go to bed. Within a month she had the BMI she needed. I'm not suggesting you do this. I'm just telling you what happened to her. Good luck whatever you decide

I gained weight to qualify and I have no regrets. The fact is, my weight kept creeping up and I would have eventually got to the qualifying weight without trying, so why not just get it over with? I also agree with wearing some heavier clothes. I wore jeans, thick socks, and thick knit top. Do check to make sure your insurance company does not require a history at that weight though. My insurance (Kaiser Fremont) did not.

I knew just diet and exercise was not going to work for me. I had spent years dieting and exercising and even hypnosis. The sleeve is tough, but I am so grateful to be only overweight, not obese and not morbidly obese. And I'm on my way to a normal BMI. I truly wish I could have controlled my eating, but I had to face reality- I couldn't.

Best wishes on your journey!

Lynda