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BMI 35 and insurance approved? ?



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I'm here I'm 34.7 bmi with borderline diabetes' date=' high cholesterol and mild sleep apnea with reflux. I'm having surgery tommorow ! Nervous and I don't realty feel supported since I don't have a lot of weight to lose.[/quote']

Mine is 34.5 now and I am having mine 10/23..no worries dear, you have to do what's right for YOU..you will get support here on this forum so don't worry. I pray you a speedy recovery..and success...

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Edited by woo_woo

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I was approved without any difficulties . Surgery was 10/1/13. I am one week post op. Lost 12.2 the first week and 17.6 since pre op diet. BMI was 36 something and is now 32.

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Wow impressive! Congrats on your losses so far!

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Hi! My surgery was on 9/18...and I lost 17 pounds...I'm in a stall for a week and I hope this finished soon! I feel that I'm loosing inches so its good! I'm happy with my decision...good luck to all :)

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Oh and my sugars levels are ok, no metformin!

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Started with a 35 BMI, was told to lose no weight before surgery on 5/17 - down 56 pounds and 4 dress sizes. :D

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My insurance wouldn't even discus it. Not covered for any reason. I put it on a credit card. Don't know if ill live long enough to pay it off but now with the sleeve there's a better chance that I will!

I will do that too if I get to 6 months supervision and am declined. Also am 62, with co-morbidities. Had lost about 18 lbs by third month pre-op, landing me at 230. (am 5'5)

Doctor said don't get below 220 or my BMI would be too low for Insurance co. So, am finding this slow down frustrating, and it seems like my last 6 month appt in mid Dec will never get here. Then it will take 4 weeks for approval process and THEN I will get an appt for surgery taking into Jannuary or later.

It's hard to keep my fingers crossed for 6 months. :D.

IN GR AND TIRED OF WAITING

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I will do that too if I get to 6 months supervision and am declined. Also am 62, with co-morbidities. Had lost about 18 lbs by third month pre-op, landing me at 230. (am 5'5)

Doctor said don't get below 220 or my BMI would be too low for Insurance co. So, am finding this slow down frustrating, and it seems like my last 6 month appt in mid Dec will never get here. Then it will take 4 weeks for approval process and THEN I will get an appt for surgery taking into Jannuary or later.

It's hard to keep my fingers crossed for 6 months. :D.

IN GR AND TIRED OF WAITING

My insurance company (UHC) goes by the initial weight when you first meet with the doctor. They do not penalize you if you lose weight. Your insurance may be different. Even if you have the same insurance as another person, a lot of the criteria is determined by the contract your employer negotiated for their benefit coverage. I know another person with UHC in Missouri, different employer, we both had a 6 month diet, but she had to visit a physical therapist and I did not.

Based on your height and weight, I doubt the insurance company will disqualify you. At 5'5" you could drop to 210 and have a BMI of 35. Some insurance companies require one or two comorbidities below a BMI of 40.

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My insurance company (UHC) goes by the initial weight when you first meet with the doctor. They do not penalize you if you lose weight. Your insurance may be different. Even if you have the same insurance as another person' date=' a lot of the criteria is determined by the contract your employer negotiated for their benefit coverage. I know another person with UHC in Missouri, different employer, we both had a 6 month diet, but she had to visit a physical therapist and I did not.

Based on your height and weight, I doubt the insurance company will disqualify you. At 5'5" you could drop to 210 and have a BMI of 35. Some insurance companies require one or two comorbidities below a BMI of 40.[/quote']

Thanks so much for this reply and the new information. I know I could get to 210 on my own. Meeting with my physician in a couple days. I'll check it out with her and maybe check back with my bariatric surgery group. GHP. THANKS AGAIN.

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My insurance company (UHC) goes by the initial weight when you first meet with the doctor. They do not penalize you if you lose weight. Your insurance may be different. Even if you have the same insurance as another person' date=' a lot of the criteria is determined by the contract your employer negotiated for their benefit coverage. I know another person with UHC in Missouri, different employer, we both had a 6 month diet, but she had to visit a physical therapist and I did not.

Based on your height and weight, I doubt the insurance company will disqualify you. At 5'5" you could drop to 210 and have a BMI of 35. Some insurance companies require one or two comorbidities below a BMI of 40.[/quote']

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Actually I believe 211 would be the lowest you could go to stay at bmi 35 and above for approval.

Edited by woo_woo

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I was approved at 37 BMI and am now @ 35 BMI. (20 days pre op)

I'm self pay but my doc approves if u have 30 BMI or higher.

I don't really have any co- morbidities (slightly high cholesterol which will come down with the weightloss).

So excited about becoming sleeved!

Good luck to everyone!

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I was approved at 37 BMI and am now @ 35 BMI. (20 days pre op)

I'm self pay but my doc approves if u have 30 BMI or higher.

I don't really have any co- morbidities (slightly high cholesterol which will come down with the weightloss).

So excited about becoming sleeved!

Good luck to everyone!

Good. You are getting this done BEFORE you get the co-morbidities.

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Actually I believe 211 would be the lowest you could go to stay at bmi 35 and above for approval.

Thanks for this note. I believe you are correct. Sorry for the delay in getting back to you. :)

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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.
      · 0 replies
      1. This update has no replies.
    • 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.

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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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