Jump to content
×
Are you looking for the BariatricPal Store? Go now!

How much did you lose before surgery was approved through insurance?



Recommended Posts

I am just wondering how much weight you lost before your surgery? I have to see a doctor for a year prior to the surgery being approved by insurance. I was told that they want me to lose some weight to "show" I can lose weight. I have gone down ten pounds and then up six and then stayed the same. I don't want to lose too little or too much ya know. Because if I lose too much I won't qualify. I am at 300 and can't lose too much for my BMI to fall below the required BMI. How much did you lose while waiting to get approved by insurance?

Help, Cheri:eek:

Share this post


Link to post
Share on other sites

call your insurance comapny and ask them for a copy of the requirements for Adjustable Gastric Banding coverage. Ask them specifically how much weight it is required you lose. My ins co has a complex case management department that I was transferred to and a nice woman worked it out with me on the phone and then snail mailed me a copy so that I have it in hard copy in hand. My insurance requires a 12 month MD supervised diet with MONTHLY visits (and don't miss one, not ONE or that clock starts again) and a 5% loss of excess weight. What they do is take your starting weight (the first month you start seeing the MD) and then look at your ideal body weight according to the MetLife tables. They then take the difference between those and multiply it by .05 to get 5%. Mine was 9 lbs. So I had to lose 9 lbs in a year, not bad, huh? Well I got sick in that year and ended up gaining weight (starting weight was 344, went to 371). Despite having two MD letters explaining that I gained weight from meds, etc. My insurance company said I still had to lose the original 9 lbs and denied me the first time around. I applied at 348 (so I was already losing, but that didn't matter) and I had to be 335. No budging on that.

Hope that helps, please call your ins co ASAP for what they require.

Share this post


Link to post
Share on other sites

I am just wondering how much weight you lost before your surgery? I have to see a doctor for a year prior to the surgery being approved by insurance. I was told that they want me to lose some weight to "show" I can lose weight. I have gone down ten pounds and then up six and then stayed the same. I don't want to lose too little or too much ya know. Because if I lose too much I won't qualify. I am at 300 and can't lose too much for my BMI to fall below the required BMI. How much did you lose while waiting to get approved by insurance?

Help, Cheri:eek:

What is your BMI?

http://www.barixclinics.com/surgery/bmi_calculator.jsp

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×