Gain Weight in Order to Get Approval?

[skinny_minnie_wannabe 30]

I am currently below 40 BMI, however, I have been gaining weight like crazy. My insurance denied me because I was below without two comorbidites despite the fact that I have GERD, high cholesterol, depression, and anxiety. I'm considering gaining weight then having another weigh in to submit to the insurance company. Has any one done this? If so, did it work? I know that this is probably a bad idea but I'm so close.

[lthueme 66]

That was me, I was denied my first time around for lack of documentation even though the insurance company did not say what they wanted. I was almost denied the second time because I was under the BMI requirement. I also have GERD, stress incontinence and knee pain. My doctor told me to stop trying so hard to lose weight and exercise everyday prior to surgery. I went in for another weigh in and just made the cut. Work with your doctor, the whole goal is a healthy you. Maybe they aren't writing the request properly to add the co-morbidities. You could also call you insurance to ask specifically what they want. I did that and got it in writing. Good luck!

[skinny_minnie_wannabe 30]

Thank you for your reply. Unfortunately my comorbidities aren't cover with exception of the high cholesterol and they want 5 years of documentation proving exhaustive medical intervention. Basically, they want proof that nothing worked. My family doctor told me to "play the game." I'm weighing in on Monday. I hate that I have to result to this but I think it is the only way it can go. Congrats on your surgery btw!! I hope that all is going well with the aftercare.

[lthueme 66]

I totally understand "playing the game" that is what I was told too. Good luck on your weigh in, if it is snowing wear a heavy pair of boots and sweater . Things are going well, I have an appt on Monday also for my first follow up and fill. Gradually adding foods back into my meals, seeing what I can tolerate and what may have to wait a little longer. Very happy with the way things are progressing. Keep us updated on your progress, keep the faith, it will happen.

[Tgarden 76]

I'm not sure about all insurances, but mine requires a BMI over 40 for at least 2 years. I also am not quite at a 40 and considered just gaining another 10 pounds or so, but it seems they have already thought of that! So sad that we have to jump through so many hoops just to get a surgery that will change our lives for better. Good luck to you. I'm already thinking I will be a self pay patient. Isn't it sad to pray for diabetes?

[lthueme 66]

Unfortunately, insurance companies seem to be only concerned with the bottom line, your BMI number. They penalize you for being over a certain BMI with higher premiums but yet won't pay for surgery because your BMI isn't high enough. Makes no sense. I was in the same situation and it took over a year to get my surgery approved. They should be looking at your overall health and not just the numbers.

[Eroper6 21]

I did gain weight to meet the minimum BMI. I only had about 10 pounds to gain and that meant eating what I wanted for a week! I was approved in 3 days with Blue Cross Blue Shield of Texas. Good luck!

[cutiepieinchi 158]

My friend gained weight to get to a bmi of 40 (hers was 39!) and she was approved in no time. It seems as if the insurance companies are only concerned about the bmi and not the comorbidity .

[skinny_minnie_wannabe 30]

Welp, I gained the weight and I weighed in today. My BMI is at 40.5. Now I am waiting to hear from the insurance company. It is sad that people have to "play the game" to get approved. I'm excited to finally get the go ahead. This process has taken way too long. Thank you for all of your replies!

[skinny_minnie_wannabe 30]

I called the insurance company and...I got approved!!! I'm like a kid on Christmas day. I'm waiting for the scheduler to call me. So very anxious!!

[cutiepieinchi 158]

Congrats on the approval!

[skinny_minnie_wannabe 30]

Congrats on the approval!

Thank you!!!

[Cookiesgotthis 50]

I was told my bmi had to be over 35 at day of surgery so I have been stressing on this.... Do they weigh you with clothes on? Gown? I'm hoping to be ok and not get sent home:/ I should be on my preop diet but I've just been drinking the Protein to build up protein levels cause I'm hoping not to lose too much hair! But I will start my diet tomorrow. One week to go!