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The Edge of BMI

I am in the preop stage and meet with my surgeon for the first time on Thurs. One of the questions I have is will I be denied if I lose too much weight during the 6 - month period. I have a BMI of 41, and no comorbidities. I have Oxford United Health Care, and they require a BMI of over 40...I'm right on the edge. Anyone else encountered this issue...?

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Yes I was just over and rules are rules I was approved :) p.s. I downed a liter of drink before my official weigh in just incase their scale was calibrated differently to my home one. Fyi my bmi was/ is 41 just started pre op.

Edited by MsTwist

Do you have any of the conditions that are considered co-morbid? Like high blood pressure, sleep apnea, high cholesterol, pre diabetes, or copd? Those conditions may override the borderline BMI requirement. My BMI is 39.5 but I have all of the above conditions so my surgeon sees no issue getting me approved.

I am in the preop stage and meet with my surgeon for the first time on Thurs. One of the questions I have is will I be denied if I lose too much weight during the 6 - month period. I have a BMI of 41, and no comorbidities. I have Oxford United Health Care, and they require a BMI of over 40...I'm right on the edge. Anyone else encountered this issue...?

I also had concerns about my weight and me not getting approved if I dropped a lot. I have a 3 month period for weight management. I lost about a pound every month so my BMI didn't go down hardly at all. I am waiting to hear from the insurance co.

  • Author

Do you have any of the conditions that are considered co-morbid? Like high blood pressure, sleep apnea, high cholesterol, pre diabetes, or copd? Those conditions may override the borderline BMI requirement. My BMI is 39.5 but I have all of the above conditions so my surgeon sees no issue getting me approved.

I have no co-morbidities, not even borderline, which even my primary is shocked by.
  • Author

Yes I was just over and rules are rules I was approved :) p.s. I downed a liter of drink before my official weigh in just incase their scale was calibrated differently to my home one. Fyi my bmi was/ is 41 just started pre op.

Thanks, that is encouraging. I would like to try and lose some, or at least use the period to get ready for what will be a huge change in my life. Good luck with pre-op!
  • Author

I also had concerns about my weight and me not getting approved if I dropped a lot. I have a 3 month period for weight management. I lost about a pound every month so my BMI didn't go down hardly at all. I am waiting to hear from the insurance co.

I wish I only had a 3 month wait. Good luck with insurance approval!

Do you have any of the conditions that are considered co-morbid? Like high blood pressure, sleep apnea, high cholesterol, pre diabetes, or copd? Those conditions may override the borderline BMI requirement. My BMI is 39.5 but I have all of the above conditions so my surgeon sees no issue getting me approved.

I have no co-morbidities, not even borderline, which even my primary is shocked by.

My best friend is just like you, healthy in every sense except the extra weight. Why do insurances have to be such a pain? We are just asking for help :(

Three words: Half pound weights.

In your pockets, bra and underwear.

You didn't hear it from me.

Three words: Half pound weights.

In your pockets, bra and underwear.

You didn't hear it from me.

Is the weight requirement only necessary for my initial PCP visit? Like is it okay if I'm under 40 bmi for the other 5 visits prior to the surgery?

  • Author

My surgeon's office said that it doesn't matter if I lose weight, and that the only number that is reported is the one from today. That was encouraging. And, it was close...I've had bronchitis the last 4 days and have lost weight. It will be back next week, like that "friend" that won't leave at the end of the party...

I have kaiser and I had the same issue. I had a starting BMI of 40 and I knew that if I lost the requested 10% of my body weight that I would be below 40 and I didn't have comorbidities. Halfway through the classes I asked if I was going to be disqualified and she said absolutely not. She was right, it was never an issue.

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