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Help...is that right? BMI must stay at 40 for 6 months?

Carrie T

By Carrie T, in Insurance & Financing

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Carrie T    14

Carrie T
Posted

I have my surgery booked with Dr. Kelly in January, but told my husband I'd give our insurance one more try...

I have a BMI of 37-38 with no co-morbidities. With my insurance I have to be on a 6 month supervised diet. I get that I would need to be at 40 to qualifiy, but I wouldn't want to stay at 40 for the entire 6 months. When I called BCBS I asked and the rep said that my ending weight needed to be at 40, or 35 with 2 co-morbidities.

Does that sound right?

Thanks for any input or experiences that you can share to help me out!

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2bfit    62

2bfit
Posted

that sounds about right. The minute you fall below 40 you have to have comorbs to qualify. I have heard of some people buying ankle weights and other inconspicuous weights for the monthly weigh ins. Some people wear the ankle weights with boot flare jeans and have a large lunch before being weighed in. I know that might sound like cheating but consider the alternative. Just food for thought. ;)Good luck!

Cheri

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skinnynursebetty    23

skinnynursebetty
Posted

I have BCBS of IL. not sure if your's is the same but with my insurance it states in the policy that they take the BMI from the first visit with the doctor, that is the BMI they use for qualifying for surgery. They WANT to see you lose weight and therefore your BMI go down. Like I said just my insurance and policy, but I would look into it again. What would be the point of a 6 mo sup diet if you didnt lose weight hence BMI going down? Good luck!

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5DogMa    62

5DogMa
Posted

I was told they base it on your weight when you start with the bariatric surgeon since most doctors will require you to lose some weight before surgery. Then I've also heard the same as above. Wear ankle weights to keep your weight up. Why can't we get straight answers out of our medical insurance companies!!!! When I started I was 42 BMI now I'm at 38, but then after all this testing found out I had 2 co/morbs so I'd still qualify. Since I don't trust my insurance company to tell me the truth, I'll be sure not to fall below 35 BMI to qualify.

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