Due to complications with my band, my doctor is recommending revision to the sleeve. However, my insurance company requires a BMI of 35 or greater even for revision surgery (I also have to do the doctor supervised diet program again). I am 8 pounds below a BMI of 35 so I can either have the band removed in which case I will automatically get fat again and then have the sleeve done as a second surgery or I can use all the tricks in the book to gain the 8 pounds necessary to get to a BMI of 35 so I can qualify to have the revision in one surgery. If I couldn't lose the weight before the band and the band helped (albeit with complications) does it make sense to force me to gain back weight I worked so hard to lose so I can qualify for a revision and hopefully get to my target weight? Does this make any sense????

What insurance do you have? I thought that if there were complications with the band and a revision was medically necessary, it was all good? I dont think thats normal and is a bit absurd. I could see if the dr said there was nothing wrong with the band and it was just you, but thats not the case....... learn something new everyday!!

Wow! It seems like they would go from your original BMI. That is horrible!

I don't really know how your insurance works, like after you gain the 8 pounds, do you have to wait two years?

But looking at the number, it's only 8 pounds. That might not even be a full pant size. That seems so little for a procedure that you'll lose within the first week post-op. If you are really considering that this surgery is right for you, I think it would be worth it (but that's just my opinion). 8 pounds for a life time of a healthier you.

Hell, stop complaining and gain the weight already.....atleast I would, I had to pay for my revision on my own, so if your insurance wants to pay for it, let them...

Jeepers... what about wearing some extra clothes for the weigh-in? (Rolls of quarters in your pants?) I suppose that is "weight fraud" -- if that even exists. That's just insane!

Hell' date=' stop complaining and gain the weight already.....atleast I would, I had to pay for my revision on my own, so if your insurance wants to pay for it, let them...[/quote']

Is it really safe to keep goin up and down the scale? Thats y we are all here in the first place!! Its not about just sticking it to the insurance. her health is first..

Jeepers... what about wearing some extra clothes for the weigh-in? (Rolls of quarters in your pants?) I suppose that is "weight fraud" -- if that even exists. That's just insane!

Kimber...lol. something else they will bring upon the overweight ones. Lying about our weight increase. Extra outfit.. definately. Good suggestion

I had a friend that was doing the HCG diet and her insurance would only pay until she got to a certain weight so she would wear sweat pants that were tight at the ankle and she wore ankle weights above the cinched in area........LOL.

Thanks for all of the suggestions. I was already planning on the rolls of quarters, but now will be buying ankle weights this weekend!

Thanks,

Tom

I had the same problem with Aetna. Even though i met the criteria for my revision, they kept denying it until my BMI was back over 40. A tip, make sure your height isn't too high in your chart. If they rounded up, ask them to round down. (I'm 5'3.5", I usually state 5'4" but asked them to record it as 5'3".). Good luck.

Do you have a copy of your insurance company's Bariatric policy? If not, get a copy of it and read it very thoroughly. One thing I discovered during my appeal process is that if you use their own language against them they will approve you. Do not go by what someone tells you. I had everyone tell me several different reasons why I had to complete the six month supervised weight loss program despite the fact their policy explicitly stated they covered both revisions and repeat surgeries due to erosion or slippage. I took their paragraph on their rationale for the weight loss program and successfully argued every point. I got my appeal approved when no one else could. You are your own best advocate. You just have to be smarter than they are because honestly, most of them don't know much about Bariatrics or the specifics of their policies. Good luck!

If you want something bad enough you will compromise to get it....its not like you have to gain 25 pounds or something...its 8 pounds, Water weight.....drink alot of water before the appt and you'll probably make it....

Insurance companies say these things just to get these kinds of responses out of people, to discourage you from doing it....

If you want it, you will not let 8 pounds stand between you and success!

And I am entitled to my opinion, if you dont want it, dont post questions on the public forum!

That's easy-- its winter, boots, heavy clothes- they don't weight you naked. Leg weights just get 8#! Our healthcare system is broken its a hoop get jumping . We all do it.

If you want something bad enough you will compromise to get it....its not like you have to gain 25 pounds or something...its 8 pounds, Water weight.....drink alot of water before the appt and you'll probably make it....

Insurance companies say these things just to get these kinds of responses out of people, to discourage you from doing it....

If you want it, you will not let 8 pounds stand between you and success!

And I am entitled to my opinion, if you dont want it, dont post questions on the public forum!

PEVette, I do want it and will make sure my weight is up to the 35 BMI requirement. I am just in shock that the insurance company is requiring it.

Thanks!

Definitely round down the height. I was self pay when I did the band and would have made the insurance requirement but I thought I was a bit taller than i was! I still would have needed to gain a couple of pounds, but heck, I'm really really good at gaining weight

It is really stupid what they make you do. Especially as while I've been working toward my revision the doctor said that recent weight gain is bad because that fat nearly always goes right to the liver and makes this surgery more dangerous. So if you do gain it, try to lose it again!