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BMI 35 and insurance approved? ?

I would like to know if anyone here has the same situation. I have 35.2 bmi, diabetes, hbp and gallstones. ...so I need to remove my gallblader too...Can anyone share experiences or advise please??!

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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.

  • Btw I have many illnesses because of obesity. I'm 4'11" and weighed 200. I'm 62. Wanted the last 20 or so years to be healthier and happier.

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i was a 36 bmi and have bcbs of tx and its a no for me..lol.. but im going to be a self pay in mexico 10/10...

  • Author

Hi, I got my approval very fast! Bmi 35.2 and lose 17 pounds before surgery. ..yes we can...nothing its impossible, just we need to try...

  • Author
i was a 36 bmi and have bcbs of tx and its a no for me..lol.. but im going to be a self pay in Mexico 10/10...

Good luck in your surgery!!!!

My BMI was 35.3 when I got started on this journey in January 2013 and Aetna denied me stating that I needed to be Obese for at least 2 years before they would even consider it, I have only been considered over weight for about 1 year because I had 2 knee surgeries and back issues after a bad accident...so I packed on the pounds being less active.... I have sleep apnea, high blood pressure and hyper tension. I was very upset and left that surgeon because they let me get all the way up to a week out from surgery to tell me I was denied and that they were sorry this was a new requirement of Aetna ...this was a lie the coordinator was just careless.

I switched surgeons, and hospitals and got Priority Partners Insurance and, Allof my records were transferred so I didn't have to start over from scratch but this surgeon had a few more requirements which I was good with...because my BMI was just at the threshhold I was only asked to lose about 5 lbs but lost 7lbs...they submitted to insurance but I was denied because they said I wasn't serious about losing weight...that was in July..then my doctor resended my application and we worked on weight loss for anothr few weeks and I lost about 4 more lbs for a total of 11 lbs. We then resubmitted and I was denied again..guess why? Because my BMI was too low...SMH. I was so upset because THE INSURANCE is the one who said I needed to lose the weight to begin with. My doctor did a peer to peer and submitted my food diary and I just got apporved Thursday September 5th. I will get my surgery date on Monday. I am so excited. I started ti feel like it just wasn't meant to be. Keep your head up it will turn around..insurance companies just don't like to pay for surgery....period. and this to them is elective,

BMI 36 with sleep apnea. Approved by NJ Direct 15. Sleeved on 4/12/13 and down 60 lbs, I feel great!

  • Author
My BMI was 35.3 when I got started on this journey in January 2013 and Aetna denied me stating that I needed to be Obese for at least 2 years before they would even consider it' date=' I have only been considered over weight for about 1 year because I had 2 knee surgeries and back issues after a bad accident...so I packed on the pounds being less active.... I have sleep apnea, high blood pressure and hyper tension. I was very upset and left that surgeon because they let me get all the way up to a week out from surgery to tell me I was denied and that they were sorry this was a new requirement of Aetna ...this was a lie the coordinator was just careless.

I switched surgeons, and hospitals and got Priority Partners Insurance and, Allof my records were transferred so I didn't have to start over from scratch but this surgeon had a few more requirements which I was good with...because my BMI was just at the threshhold I was only asked to lose about 5 lbs but lost 7lbs...they submitted to insurance but I was denied because they said I wasn't serious about losing weight...that was in July..then my doctor resended my application and we worked on weight loss for anothr few weeks and I lost about 4 more lbs for a total of 11 lbs. We then resubmitted and I was denied again..guess why? Because my BMI was too low...SMH. I was so upset because THE INSURANCE is the one who said I needed to lose the weight to begin with. My doctor did a peer to peer and submitted my food diary and I just got apporved Thursday September 5th. I will get my surgery date on Monday. I am so excited. I started ti feel like it just wasn't meant to be. Keep your head up it will turn around..insurance companies just don't like to pay for surgery....period. and this to them is elective,[/quote']

Oh my god, I'm so sorry about your history....but you are approved! !!! Super happy for you, and I honestly thought that they never will approved me, but I'm blessed my insurance doesn't required a lot of things like I see with other people here, oh btw my insurance is state insurance, like Medicaid....

Thanks...yes some insurances really give you the business but I finally got over the hump. I'm really excited..more worried about failure..I'm reading stories about ppl not losing when they don't have 100 or more lbs to lose..

That's great to hear you lost 60 Lbs in less than 4 months...awesome!! I can only pray I'm that fortunate..it's crazy you wanna lose it and then you worry what if I lose too much? I met a woman who has GP and she looked very unhealthy and old...and she was young. She was 400 lbs to start though but still she said she had lost so much weight at first she looked scary...said she was happy she gained some back..but to me she still looked ILL so I dunno I just gotta stop comparing..

Thanks...yes some insurances really give you the business but I finally got over the hump. I'm really excited..more worried about failure..I'm reading stories about ppl not losing when they don't have 100 or more lbs to lose..

My ins wouldn't even discuss it. I charged $12,000 to my credit card and did it any way. I've gone down two dress sizes and lost 35pounds so far in 3 months. I don't care about the debt. It's not as important as good health.

  • 2 weeks later...
  • Author
Ready' date=' I thought I'd give you an update! I'm sleeved!!!! Yay!! 5 days post op today and doing pretty well. Looking forward to full liquids next week. Heard anything from your insurance yet? Don't give up...[/quote']

How are you???

Congrats I'm glad you're doing well. I still don't have a date because of the coordination between surgeons for my double surgery, but I'm hoping this week I'll get one.

So glad you're feeling good. Keep us posted.

My doctor's office and I have received verbal approval from ins. co. for my surgery. In order to get a surgery date, my doctor's office requires a written letter. The letter was mailed on 9/18. Hope it arrives on 9/25. I started with a BMI of 35.

I am a band to sleeve revision patient. My ins. co. waived the six month supervised diet criteria due to band complications.

Looking at a 10/8 if available by the time I get written approval. If that date is unavailable I will have to wait until 10/25 due to work obligations.

  • 2 weeks later...

I'm here I'm 34.7 bmi with borderline diabetes, 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.

  • Author
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']

Hi! Hey congrats with the approval! Well, I had my surgery 2 weeks ago, and the day of the surgery my bmi was 34...I felt like you, but everyone have their own journey, and I did! I lost 17 pounds, and I'm very happy with my decision... So go ahead, good luck, and speedy recovery!!

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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