I have BCBS Federal. I am required to have 3 months of a monitored diet, which I will do with my surgeons dietician, before my surgery. My question is, if I lose weight during that 3 month window, prior to the surgery and my BMI falls below 35 (which it will if I lose more than 5 pounds) will that prevent my insurance co from approving my surgery? Or does the only weight that matters is the weight I start at when I first started seeing the surgeon and my weight during the 2 years prior to the surgery?

Thanks!

It's your initial starting weight that counts (at least in my experience.) I started out prior to the supervised diet at 37 and am now at 33.5 just a couple of days before surgery. I think I was somewhere around 35 when approved, but they had the info from the initial visit to make their determination on.

After I was approved by the bariatric team, I was required to take a nutrition class (in addition to the monthly meetings I was having the the nutritionist). We are also required to do a pre-op weigh in within the two weeks prior to our surgery date. During the class it we were told that the pre-op weigh in is the one that counts for the insurance company. Its the one they will submit when requesting approval.

I too was concerned about dropping weight because BMI just makes the cutoff. If I had dropped ANY weight I would have not met the required minimum . After my approval from the bariatric team I was worried about approval from my insurance. So during my next monthly with my nutritionist I asked her, in her experience what were some of the reasons for denial from insurance. She did say she had at least one client who was denied because he/she lost enough weight prior to the 2 week pre-op weigh to bring their BMI below minimum requirement.

If I were In Your shoes I would ask that question to every member of the team I met with, just to make sure. It's always comforting when you get the same answers from difference sources

The only way to know for sure is to call your insurance company- they will be able to tell you for sure what your policy covers.

I have Tricare and we were told that our BMI on the day we started the program was our official weight, and even if we dropped below 35 during our pre-op phase our surgery would still be approved for surgery. Not an issue for me, but some of the other people in my orientation were concerned about that.

I am on my last month of of 6 month pre-op for insurance and the dr following me said that with my insurance I cannot drop below 40bmi or they will not pay. I started at like 40.7. So I have purposely not lost weight and am nervous that they will deny me because of that