if I lose weight during the six-month period and fall below my BMI will my surgery be approved

Ask your insurance, but they usually go with the starting BMI.

if I lose weight during the six-month period and fall below my BMI will my surgery be approved

I have Aetna and was not able to fall below 40 BMI before my surgery. I also could not gain any weight so I had to stay within a 7 pound range for 4 months before my surgery.

I have Oxford United healthcare and am not allowed to lose below 40bmi. Some insurances go by the starting weight, many do not.

Edited February 20, 201511 yr by Debranua

Sorry I was typing on my phone. 40 bmi not 49.

I'm not in the US but just thought I'd say I asked my surgeon the same question two days ago - he said because my higher BMI is documented, he'll still do it even if I drop below his BMI lower-limits.

He said it would be different if I came back with a BMI if 25; I laughed and he joined in. Thanks for the vote of confidence there, doc

I had my first consultation this week. I was told that I now had to pay the "insurance game." I couldn't not lose weight because then the insurance company would determine I wasn't motivated and if I lost too much, they would determine I could do it on my own. I have a BMI of almost 44 with comorbidities of sleep apnea, high blood pressure, high cholesterol and a fatty liver so technically would still be a candidate with a BMI of 35. But, I'm just going to be very friendly with my scales for the next four months, the amount of time that I have to be on a medically supervised diet.

My BMI is 35. My bariatric doctor said not to lose too much weight on the 6 month pre-op diet. My PCP, however, lectured me about how the insurance companies want to see that you can stick to a diet because if you can't do it before the surgery how are you going to do it after the surgery? So I have to keep a food/activity log (been there, done that- haven't we all?)

Let's look at that logic for a minute: If you could stick to a weight loss/maintenance diet on your own you wouldn't be obese. Haven't we all been on every diet out there? And the whole purpose of WLS is to give you a tool that will help you eat the smaller amounts of healthy foods that will result in weight loss.

My insurance requires co-morbidities with a BMI of 35 - right now they have me down for hypertension and elevated cholesterol but my bariatric doctor thinks they put more emphasis on sleep apnea and diabetes. So I will be getting the sleep study - which after my last one I said I would rather be dead than get another one. But here I am.

Just think how much simpler all this would be if we all had the money to pay for the surgery ourselves and not depend on the logic of insurance companies.

I was told to lose some weight but not to fall.below the bmi. Just to show I can lose weight. I lost 7lb but gained 2 back. But didn't go over my start weight

It depends on your insurance. You should call them up and ask them what their policy is. Some require a BMI of 40 (if there are no comorbidities- high blood pressure, diabetes, sleep apnea, high cholesterol...) if comorbidities then at least a BMI of 35.

If they require months of nutrition counseling the weight they go by is the last month. So you would need to have the required BMI at that point.

My BMI is 35. My bariatric doctor said not to lose too much weight on the 6 month pre-op diet. My PCP, however, lectured me about how the insurance companies want to see that you can stick to a diet because if you can't do it before the surgery how are you going to do it after the surgery? So I have to keep a food/activity log (been there, done that- haven't we all?)

Let's look at that logic for a minute: If you could stick to a weight loss/maintenance diet on your own you wouldn't be obese. Haven't we all been on every diet out there? And the whole purpose of WLS is to give you a tool that will help you eat the smaller amounts of healthy foods that will result in weight loss.

My insurance requires co-morbidities with a BMI of 35 - right now they have me down for hypertension and elevated cholesterol but my bariatric doctor thinks they put more emphasis on sleep apnea and diabetes. So I will be getting the sleep study - which after my last one I said I would rather be dead than get another one. But here I am.

Just think how much simpler all this would be if we all had the money to pay for the surgery ourselves and not depend on the logic of insurance companies.

the totally "game play" is ridiculous

@@taweedeegirl did you fall below your BMI before papers were submitted??

If I go under 35 my insurance will not approve me. They don't care if I stay the same or gain slightly, but I cannot go under. I have a BMI of 37 with comorbidities. I would totally check with your insurance.

@@Rolla6 I dropped below 40 for 1 month. But...I just found out tonight that I was approved, so apparently they didn't penalize me for that. Thank God. I was definitely worried..

@@sassyfrass23

Yay! How exciting! Do you have a date yet?

Not yet, @@Rolla6 ! I was hoping for March, but I actually believe it will end up being in early April.