BMI of 33, any way to have band covered by insurance?

[Griffingal 0]

Hello all! I'm new. I just had a meeting w/ a Dr, and it turns out that for the first time in ten years, I'm not fat enough!! Don't get me wrong... w/ a BMI of 33-34, I'm by no means just retaining a little Water. But, the MD said that there was no way that the surgery would be covered unless my BMI was above 35. UUGGGHHHH! :angry Any one else out there run into this? Is there any way around it? Loopholes, anyone? Or should I hang out w/ Ben and Jerry for another six months and go back?

:help:

[marjon9 6]

I think Ben & Jerry's is your best bet. Just stay away from Subway Sandwiches. Eating Subway makes you lose weight (right).

To tell you the truth, in your position I would seriously consider self-pay. There are options with excellent surgeons for under $10,000 in both the U.S. and Mexico. With financing it can be just a few hundred a month and you'll probably be able to cover most of those costs with lower food and medical bills. You will improve the quality of your life in the process and, if you are like many of us, you will actually even save your life.

A BMI of 33 is not that high and you are losing weight already. Maybe you are actually one of those who can turn things around with diet and exercise. There is no doubt that this can be done, it's just really hard for most of us. If you are going to try that I would recommend a really helpful book I found (after I was banded) called The Four Day Win by Martha Beck.

Anyway, let us know how it goes.

[Sissy907 1]

I recieved a call today from the doc/surgeon saying that my refferal was returned to him. Apparently I don't have enough wrong with me. (I wrote a post on the introductions page about all my health issues) But to me this is absolutely rediculous. Why won't someone just look at this and say hey, she is gonna be in big trouble if we don't do something to help now... He rewrote the refferal and is sending it back, and told me if that doesn't work that he would send me for a sleep study to see if I had sleep apnea. I don't think I do. My husband does and I don't snore ANYTHING like him!! (he has woken neighbors before!)

He also was very pushy in that he really didn't think the band was for me. He said that it may make my heartburn issues worse or make it not change at all. I feel like he is pushing me to do things his way and not really listening to what I want. I told him the dietary needs/restrictions and the life style changes that were required for that surgery was somethng I really didn't think I would be able to adjust to. Where as with the band, if I desperatly needed to have a bite of chocolate I could, and I wouldn't "pay for it" by puking and crapping my brains out. (And when has anyone with severe "choco-holic syndrome" ever been able to completely give it up? lol) I feel more comfortable with the band in that I can eat the way I need to loose the weight but yet I can have the occational treat when I just can't hold out any longer. I like that this surgery isn't going to do the work for me, I am going to have to EARN it. I, much like a teen, work better if I have to earn something rather than just having someone give it to me.

I don't have comorbidities, I am sort of a healthy fat person. I have at the very least 98 pounds to loose. But as far as this doctor is concerned I am to thin! So how do I get a surgery done, that my insurance will pay for, at a bmi of 36.9? Eat more? Gain more weight? My husband would certainly not go for that idea...

I don't like to give out to much info on the internet, but my problem is we are military. My options are SO limited it's not even funny. I don't get to choose my doctor. I don't get to appeal. Tough luck, to bad, have a nice day... *cries*

*SOBS*

*looks for some ice cream*

Any ideas? Anyone else military that had to deal with this issue? :help:

[kbrier2703 0]

iam also at a 33 % bmi. i was told to do the test anyways and submitt the paperwor and see what happens. have test later next week, second guessing if i should go through all the trouble to just get denied. wish i could find someone that got approved with bmi of 33 % so i could be more optamistic.

[BetsyB 9]

(And when has anyone with severe "choco-holic syndrome" ever been able to completely give it up? lol)

I have.

To the OP, no--there's no way you will be covered by insurance if you don't fall into the very specific parameters defined in your policy. The contract guides it all.

[GermaineF 25]

I have a BMI of 35 with high blood pressure, I just went thru my 6 months of supv weight loss that my insurance required and the psyc eval to find out that i was DENIED!!!! I'm beginning to cry as I type this b/c I'm so frustrated. My dr's office said that they will submit more paperwork and see what happens...Oh i have BCBS

Down and Out....

[lizzy2150 3]

Rolls of quarters in your pockets when you get weighed?

[Slim Down Donna 2]

I recieved a call today from the doc/surgeon saying that my refferal was returned to him. Apparently I don't have enough wrong with me. (I wrote a post on the introductions page about all my health issues) But to me this is absolutely rediculous. Why won't someone just look at this and say hey, she is gonna be in big trouble if we don't do something to help now... He rewrote the refferal and is sending it back, and told me if that doesn't work that he would send me for a sleep study to see if I had sleep apnea. I don't think I do. My husband does and I don't snore ANYTHING like him!! (he has woken neighbors before!)

He also was very pushy in that he really didn't think the band was for me. He said that it may make my heartburn issues worse or make it not change at all. I feel like he is pushing me to do things his way and not really listening to what I want. I told him the dietary needs/restrictions and the life style changes that were required for that surgery was somethng I really didn't think I would be able to adjust to. Where as with the band, if I desperatly needed to have a bite of chocolate I could, and I wouldn't "pay for it" by puking and crapping my brains out. (And when has anyone with severe "choco-holic syndrome" ever been able to completely give it up? lol) I feel more comfortable with the band in that I can eat the way I need to loose the weight but yet I can have the occational treat when I just can't hold out any longer. I like that this surgery isn't going to do the work for me, I am going to have to EARN it. I, much like a teen, work better if I have to earn something rather than just having someone give it to me.

I don't have comorbidities, I am sort of a healthy fat person. I have at the very least 98 pounds to loose. But as far as this doctor is concerned I am to thin! So how do I get a surgery done, that my insurance will pay for, at a bmi of 36.9? Eat more? Gain more weight? My husband would certainly not go for that idea...

I don't like to give out to much info on the internet, but my problem is we are military. My options are SO limited it's not even funny. I don't get to choose my doctor. I don't get to appeal. Tough luck, to bad, have a nice day... *cries*

*SOBS*

*looks for some ice cream*

Any ideas? Anyone else military that had to deal with this issue? :help:

I had to do the six month PCP monitered weight loss. I weigh in with shoes, sweaters, the heaviest jeans I can find, and lots of change in my pockets. I also drink alot of Water just before weigh in. So everytime you weigh in find things to make you heavy.

[katwomantexas 2]

I had a BMI of 34 and was told to gain 2 pounds and come back. I did that and the 6 months of doctor visits and was approved in 3 days. Thats what I did and I am now 5 months since surgery.My life has completely changed for the better.

Kat