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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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Edited by woo_woo

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.

Wow impressive! Congrats on your losses so far!

  • Author

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 :)

  • Author

Oh and my sugars levels are ok, no metformin!

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

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

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.

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.

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']

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

Edited by woo_woo

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!

  • 2 weeks later...
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.

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. :)

  • Author

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...

Heyyyyy how are you????????????

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