Skip to content
View in the app

A better way to browse. Learn more.

BariatricPal

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.

Join BariatricPal free

  • Ask your own questions
  • Reply and follow topics
  • Message other members
  • No cost, no spam

Im at 40 BMI and insurance says that is cut off but have me on 6mo healthy weight phone coach

So do I try to lose weight go below cut off? I'm half way through and have lost 7lbs..
Has anyone else gone through this? My family DR said don't lose anymore until insurance approves. I just wondered if I don't show ive tried if they will turn me down. VERY frustrated playing the game

  • Replies 7
  • Views 1.1k
  • Created
  • Last Reply

Featured Replies

I totally understand your frustration! I was in a similar situation but I had to make monthly doctor appts for 6 months. So I stayed at about the same weight, just fluctuating up and down. Just try and play their game and you will get through it.

Why not ask them straight up. Get them to put it it writing too. You have the support and records of your general physician. Surely, his or her objection to this six month regime should carry some weight...(pardon the pun).

They know the date you started this and they know your start out weight and BMI so surely your start BMI will count.

Hope you get the answers and the outcome you want.

Xx

  • Author

I have a letter Dr wrote to ins company saying I needed surgery asap. The surgeon filed and I was denied. I contacted insurance 2times and talked with 2people and received two answers. One I need to be 40 Bimini and another told me they expected weightloss. I have not had anything in writing. I WILL CALL AGAIN.

Im also going thru this. I have a BMI of 36, but also have many comorbidities. My insurance is known to deny for not having a high enough BMI. My dr told me that he was not able to tell me to "gain weight to make criteria" but that if I did, "it would help get me qualified" So that being said.... I had to gain like 10lbs.... but that is harder than one would think when u already have the losing weight mind set. Ugh!

I have been having the same issues. I was denied surgery after 6 mos because I did not have comorbidities. Resubmitted twice and they still denied. I am starting over again. But I intentionally gained 20 lbs to spike my sleep apnea. I had to take the test and then report that I cannot use the CPAP to control my apnea. How dumb it that!

The insurance company has since approved me for the 6 mos. I have to start all over again. I have to attend nutrition counseling, get a psych eval and lose the 20 lbs I had to gain. It is crazy what one has to do to get insurance coverage. Before I started this whole process I had to have my lapband removed. So I am hoping the third time is the charm.

It just makes no sense what we have to go through. Good luck to you!

Archived

This topic is now archived and is closed to further replies.

Account

Navigation

Search

Search

Configure browser push notifications

Chrome (Android)
  1. Tap the lock icon next to the address bar.
  2. Tap Permissions → Notifications.
  3. Adjust your preference.
Chrome (Desktop)
  1. Click the padlock icon in the address bar.
  2. Select Site settings.
  3. Find Notifications and adjust your preference.