New to this journey

[SouthernPeach 1]

I've made the decision that I want WLS. I'm about 15lbs below my "goal" BMI for qualifying for my insurance to cover this. I've read about adding weights, etc to help get over the threshold. However, I feel guilty about doing that. If you do it the first time, do you have to do it for EACH weigh in? Also, does the doctor submit your highest weight when submitting paperwork to the insurance carrier? I'm wondering about the 3 month mandatory weight loss meetings and what happens if you lose weight during that timeframe.

I simply can't tolerate trying to gain weight while in the "lose weight" mode. I have heart failure and I work hard enough dealing that, which is also my inspiration for WLS. I want to take the extra burden of excess weight off my heart.

Any suggestions?

[SandyM 1,956]

Talk to the insurance handlers at your WLS clinic. They will be able to tell you what the insurance company is expecting. Mine told me that they use the very first weight. They said the insurance company actually expects you to lose some as this shows your committment. I have to admit I was nervous about it right up the the time I was approved though. So, check with them, they have alot of experience with this.

[BigGirlPanties 957]

your heart failure/condition may be enough of a pre-qualifier...

check on the details with doctor and insurance... i agree

[Kelly Gonzalez 52]

I was told to lose weight, the more the better, and I started out at 278, when I finally had my surgery on 3/31 I was down to 257lbs. My doctor told me that the insurance won't pay, if they don't see a loss from your beginning weight, but I guess all insurance's are different. Plus your general health, if it's bad will also be helpful in them doing your wls. So good luck on your journey.

[2muchfun 8,928]

How accurate is your height with the doc? I know most people fudge their height be .5-2 inches. Be shorter!

[Miss Mac 6,262]

After I completed my pre-op progam, the surgeon's office sent in the request quoting my original weight on the first day I came in the door, I am glad he did because I lost over 20 pounds post-op and would not have qualified so easily.

[SouthernPeach 1]

^{Do the doctors measure your height or do you report it yourself? I haven't seen the doctor yet. My first apt isn't for a couple of weeks.}

Edited April 10, 2014 by SouthernPeach

[2muchfun 8,928]

^{Do the doctors measure your height or do you report it yourself? I haven't seen the doctor yet. My first apt isn't for a couple of weeks.}

They measure you. You probably only need 1 inch to make the BMI limit so try to be a little shorter than you think you are.

For example, If I was 1/2 inch shorter, my BMI goes up .5. Work it girl!

[Ginger Snaps 1,323]

I'm in a similar spot. If I drop 4 pounds or more I won't qualify for the surgery my insurance doesn't require a loss so for now I just have to maintain what I have. Weird that for the first time in my adult life I'm actually not trying to lose weight!

[J-Cal8 13]

The insurance companies go by your start weight, so if you loose some before surgery it's ok

[BandedBrunette481 310]

When I was trying to get insurance approval, I was about 10 pounds away from qualifying. My surgeon's office didn't specifically tell me I needed to gain weight, but they were kind of happy when I said I gained 5 pounds over the holidays and then told me they were "really looking for a BMI of 40" at my next appointment. I just ate a lot before my appointment and wore my heaviest clothes for the weigh in lol. You should have seen the nurse's face when she asked me if I wanted to take off my light jacket and I said no hahaha! I made the cut off and my insurance company approved my surgery in 9 days after the case was submitted. Once they agreed to pay, I didn't HAVE to keep my BMI over 40 anymore, but I didn't feel like dieting when I didn't have too, so I stayed at the same weight until my pre-op diet. I don't regret gaining the extra pounds so I could qualify for surgery even a little bit!

Obviously you should do what's best for you, but I just wanted to share my experience. Best of luck to you

[SouthernPeach 1]

Blissfullybanded,

Our starting weights and goal weights are the same. I'll be calling the hospital shortly to have my first chat with them and see how it goes. I'll also wear a jacket, that won't "need" to be removed.

[Bandista 7,466]

My insurance company had one requirement only, the 40 BMI and no exceptions to that even with high BP, apnea, etc. I was so worried about this! I could not get a handle on which weight would be submitted but it turned out it was the weight on the day I first saw my surgeon. This was after meeting the LB coordinator, nutritionist and psych eval. I guess that surgeon visit is just when my hospital chooses to submit. Each appointment I wore heavy jeans and hand weights in my pockets, big jewelry, drank a big bottle of Water, etc., and I worried like crazy every time I had to weigh in -- wish I had been savvy enough to slump for the height check, duh! Later the surgeon told me they would have let me have my handbag on my shoulder but I don't know if the nurses would have been amenable to that. Obviously they can't be directly deceitful but I think a blind eye can be turned. Best wishes -- it will be over soon, this gauntlet!

[spiritedcowgirl63 108]

I was borderline. Yes I fudge my height my whole life . Be accurate. Shorter is better. Wear heavier clothes. Drink lots if Water lol. Whatever it takes! My ins took the weight of my very first doctor visit weigh in. That was good cause I lost 20# prior to surgery 3 months later which was under the BMI requirement. Life is good down about 80# total.