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

UHC united healthcare with optimum bariatric resources.

UHC united healthcare with optimum bariatric resources.

Thank you :)

  • 2 weeks later...

My orthopedic doc said he would write a recommendation for surgery due to patella femoral something or other, arthritis, and high risk for bilateral knee replacement. You'd think that would be enough but I'm still skeptical about insurance approval... Feeling anxious.

  • 2 months later...

Just got approved! Yahoo! During my 6 months of classes I had 2 weigh ins below 40. No comorbidities. Bcbs insurance (Highmark) :D

  • Author

Had my last weigh in today so just waiting for it to be submitted to insurance. Hopefully early dec surgery date **fingers crossed**

  • 2 months later...

At my pre-op the Nurse that worked for the hospital said some insurance will deny your surgery at the date of surgery if you don't meet the above 35 bmi and the insurance person at my Dr office told me the max I could lose to be ok

  • 2 weeks later...

I am in California and have medical/Medicare. My first bmi was 39.7. with NO co morbidities. I was told then not to loose weight. I had to be 40bmi or higher. that's where I have been for the last six months. Now waiting insurance approval, but the pa I see said I may not be approved because of that first bmi. This insurance thing is so frustrating. with medical there is no person you can talk to in order to get details. Just someone setting in

front of a computer screen, say your approved or not. No details. also our doc's office doesn't pre-set a surgery date, just floating along waiting, waiting......

I am rambling, I would not loose any weight. Also my sister just had her surgery the first of Feb. She starting trying to loose weight in Jan. the nurse told her NO, NO. that if her bmi was under 40 at her pre-op appointment, that insurance would turn her down. One good thing is at our dr.s office, we will not have any pre-op diet.

  • 2 weeks later...

My BMI is now below 40. I am worried I will be denied surgery because of my weight loss. I have asthma, arthritis, and 2 knee replacements. Is that enough comorbidities to get approved?

I was told that since I do have some comorbidities, that I have nothing to worry about so long as my BMI doesnt go under 35.

<p>I was told that since I do have some comorbidities, that I have nothing to worry about so long as my BMI doesnt go under 35. </p>

I stressed so much on this, so they didn't have me do a two week diet, at the hospital the nurse was saying she has sent people home day of surgery for being under. When I got there just to be on the safe side I left my shoes and jacket on went weighed. So much relief when I weighed in ok my bmi was 37 with co-morbidity. But I know my insurance only looked at the co-morbidities as high blood pressure, sleep apnea, or diabetes.

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.

I work for a bariatric center. I am the insurance specialist. We use your bmi from your initial appointment

Me too. I was told to not lose any either. But does that show lack of commitment?

I work for a bariatric center. I am the insurance specialist. We use your bmi from your initial appointment

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OK so based on what number 12 says if a year from surgery I lose say 80lbs. And I suffer from skin problems such as rashes and infections and document it the insurance will cover skin removal?

  • 2 weeks later...

It all depends on how your policy is written and what your employer will cover. But you will have to see a plastic surgeon they will have to get you approved for the skin procedure

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