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BMI exactly 40, will I be denied if i lose any weight?

At my consultation appt my BMI was 40.05. Now I have to do a 6 month diet to get approved. My question is will I get denied if my BMI drops below 40 prior to surgery?? My coordinator assures me that the starting weight is the only one that matters but I'm not sold. I don't have any comorbidities and my insurance is BCBS.

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I am also right around 40 BMI and have been worried about my insurance covering my surgery. I go next weekend to a siminar then I can set up my first app. I've been really stressing about this insurance thing!

Make sure your BMI is at or above what your insurance requires before you go to a seminar because what vet your wgt is then is your starting wgt.

My BMI was almost 72. My insurance company said, "Get that dude under the knife!" :) Sorry carry on.

I am not gonna even lie...I gained about 12 lbs before surgery bc I was afraid of the same thing. Plus in my addicted mind I knew I was changing my relationship with food forever after surgery so I binged a couple weeks before. Two months later I'm down 37 lbs and am glad that I did what I had to do to get my new stomach.

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Thanks guy! I just decided I am going to start making better food decisions like more protein, less carbs and try and maintain my current weight throughout this supervised diet. :)

  • 4 weeks later...

Does anyone have updates on your insurance approval? I'm really curious as to what your results were. I still can't get a definitive answer from highmark and will be super bummed about being denied after 6 months of hoop jumping for being under by .1 on one weigh in. Thanks!

I have a BMI of 38 and I do have comorbidities so my cutoff is a BMI of 35. I too have been concerned about losing weight. I have my first appointment with my doctor 8/8/13. I will discuss this matter with him and post my findings after my appointment.

I am a BMI of 35 at my first visit with my surgeon. I have comorbidities. I was told by the nurse at Optima who handles bariatrics for UHC that they go with the initial weight and BMI and if it drops below, not to worry.

I have a BMI of 35.2 with type2 diabetes, asthma and sleep apnea. I was told to not lose any weight and that they would not be putting me on a pre-op diet except 2 days prior to surgery. I have Medicare and I know the requirements change with different providers. I was actually bummed because I wanted to lose weight prior to the procedure, but oh well... ????

  • 2 weeks later...

Depends on your insurance and your surgeons requirements. Both my ins. and surgeon require a wt. loss of 5% of total body wt. before surgery, which starts with the weigh in at the initial surgeon evaluation appt. The 5% is required because that percentage is necessay to shrink the liver enough so that the surgeon can work around it easier. I think the ins. company wants to see if you can stick to a wt. loss plan.

At my consultation appt my BMI was 40.05. Now I have to do a 6 month diet to get approved. My question is will I get denied if my BMI drops below 40 prior to surgery?? My coordinator assures me that the starting weight is the only one that matters but I'm not sold. I don't have any comorbidities and my insurance is BCBS.

missmee.... I'm so sorry ur having a hard time with all the hoop jumping and wait game... I love my sleeve and I'm about a month and I can't tell you the wonderful gift this is... I can help u if you wanna go another route there is no wait and no tests and the cost is only a few thousand... ill help you make this happen if you want?

I have been worried about the same thing. My BMI is 39.5 at surgeon consult. I was advised to not lose, and if I did happen to gain 7 lbs I'd be at a 40 BMI. I have BCBS and am worried with comorbidities of patella femoral syndrome (bad knees) PCOS, past slipped discs in lower back, fibromyalgia, (so I'm told) degenerative discs in neck, arthritis... But no diabetes, high blood pressure, or any of the main criteria that the insurance company thinks are valid. I met my deductible, have my last nutritional appt. Dec 2nd. Theoretically, I could have surgery in December if all stars align and I am shined favorably upon.....

Am I a terrible person for wanting to carb load to make weight?! And if I do isn't there a criteria of having morbid obesity for 2 years? What's morbid? Ugh... F*#+* ing insurance company criteria is morbid I say... ;-/ feeling frustrated and worried.

I am a BMI of 35 at my first visit with my surgeon. I have comorbidities. I was told by the nurse at Optima who handles bariatrics for UHC that they go with the initial weight and BMI and if it drops below, not to worry.

I was told exactly the same thing by my doctor's office. She said that the only weight and BMI that gets reported to my insurance company is the initial weigh in.

I was told exactly the same thing by my doctor's office. She said that the only weight and BMI that gets reported to my insurance company is the initial weigh in.

I am not sure if that is the case with everyone. My best friend was denied because she had one month below the required BMI. So be be careful. She had gone through a lot to get approved since then. Ended up having to redo her 6 month diet. And all pre op testing.

I am not sure if that is the case with everyone. My best friend was denied because she had one month below the required BMI. So be be careful. She had gone through a lot to get approved since then. Ended up having to redo her 6 month diet. And all pre op testing.

Do you happen to know which insurance company she used? Thanks :)

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