I was looking at my benefits handbook from work. It talks about how you need to have a bmi over 40 (or 50 for sleeve). My insurance requires a 6 mnths supervised diet. I lost 10 lbs last month which made me fall below a bmi of 50 (4th month visit). Has anyone been in the situation and been approved or denied for the sleeve? Wondering if they take start weight or weight when paperwork is submitted.

Edited September 22, 201510 yr by baileyj908

All insurances are different but my doctor office uses my initial weight. I know that other conditions can qualify you at a lower BMI (high blood pressure, high cholesterol, sleep apnea, pcos, copd..just to name a few) I would call your insurance and ask them directly.

I really hope they use starting weight and bmi.

I have uhc and they used my starting weight

My doctor used initial weight in his practice.

I have had both United Health Care and BCBS of Alabama during my 6 month pre-op program. It was explained to me that my BMI must be above 40 for every single weigh in during that 6 month period. If my BMI had dropped below 40, then I would have had to start all over. Insurance companies want to find any excuse NOT to pay for your surgery so if they see you losing weight on the supervised diet, they will think "she can lose weight by dieting so she doesn't need the surgery" and will not approve you. I know that sound silly but that's the way it was for me under both UHC and BCBS. I wasn't sure this info was correct so I called both insurance companies myself and they verified for me.

My surgeon uses my initial weight! Good luck to you!

You must get this answer directly from your insurance carrier as it pertains to your particular policy. Please do not rely on anyone else's experience. I barely squeaked by with a BMI of 40 and my surgeon told me not to lose a single pound. All of your visits are documented and submitted to the insurance company and I was advised to NOT "give them any loophole to deny you"

Call your insurance company and ask for specifics in writing.