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I have BCBS of Florida, The sleeve is covered if you have had a 50 BMI for at least 5 years. I have not I am only at a 40. Has anyone had this trouble but fought against to have the sleeve and won? I am covered for gastric bypass but I choose not to have my intestines moved around.

Any of you out there have had this problem?

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That;s the highest BMI prerequisite I've ever heard! Do they give any allowances for comorbidities such as sleep apnea, back/knee problems, etc?

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Never heard of that before. Since I didnt have any health problems I did have to have a BMI higher than 50. I would definitely fight it.

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I have BCBS state of Florida pop and they covered my band in 2010 and just 3/30 my revision to sleeve and I was never a BMI of 50.

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Not that I know of on the co-mobilities...........I do have several. I am going to fight this. I have my first appt Monday with the PA and then will be seeing the dietician as some point, Not sure how all this works just yet.

I just can't believe that is what they said a BMI for at least 5 years, that is crazy. If they can cover the gastic bypass with out having that, they most certainly cover a sleeve. Reason being they wont is because there is not enough research on it, hasn't been around as long as the gastric bypass..........The sleeve is less invasive and quicker recovery time, less dumping ect ect.........This is what is best for me, I WILL get this, I'll fight tooth and nail to become approved!

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Good luck Terriann. Keep us posted. You're inmy prayers.

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I have atnea and they covered almost all my expensise so far...... except for copays....I know they will no cover plastic surgery but i am 8 weeks out and very pleased with the results... good luck

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I have aetna and they covered half my bmi was 40 the problem was even though they paid half out of pocket still cast me 13, 000 I could of gone to Mexico twice :(

Sent from my SPH-D700 using VST

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
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    • Doughgurl

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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