I have a BMI hovering around 38ish (5'6", 235 lbs). I am very interested in the lap band surgery and have done all of my homework. I do not have any significant comorbidities (thankfully) - just joint pain and possible mild sleep apnea (though not officially diagnosed). I wondered if anyone out there has had any success in getting approved through insurance with a similar situation? Do I have to gain more weight to be considered? Seems crazy, but just thought I would ask about others experience.

Thanks in advance!

HI , My Bmi was 38 and I had a hard time getting my insurance to pay , I had to have my family doctor , write that I had potential issues riseing ( Like getting fatty live, heart ) Hey had to put in wrtiting that I could get these issues and that would cost my insuranc emore if I did , I really had to fight it ! Good Luck :biggrin1:

Hello I have a BMI of 36.8 and have Gerd,artheritis,hyperlipdemia,pitting edema and severe back pain.I have Cigna oap and I am almost done with all of the test before we send in the info to the ins company for approval.I am not sure what to expect a denial or an approval cause my co-morbid conditions arnt severe enough.What r your opinions on me getting approved with these conditions?

Obviously you have recieved enough answers but I was approved with a BMI of 35 but I have diabetes, sleep apnea, GERD and High bp. They warned me not to lose an ounce though cause I was at the lowest you could be. I will be banded October 13th.

Hi! I was nevous about this too. I was about 38 BMI, 215 lbs, 5' 2 no comorbids. I have BC/BS n.h. Got approved in a wk NO PROBLEMS!

Good luck!

My BMI was 33 and I had 150 pages of documentation from 3 Dr's. relating how my weight contributed to my diabetes, high blood pressure, GERD, and sleep apnea. Cigna's doctor (!!) send a denial stating that none of these issues were sufficient for the surgery.

Mt surgeon's office referred me to the Obesity Law and Advocacy Group (www.obesitylaw.com) located in San Diego (I live in Virginia). They are a free service, paid for by the Realize Band company. It took them a month, after I completed their application form and they received all 150 pages from the surgeon's office to get the appeal submitted. Within 30 days Cigna approved me, no questions or comments made!!

Yahoo! Scheduled for October 7th :tongue:.

BCBS of NC They did not approve the first time-- with these weights and BMI-- they stated they had to be 40 for 2010 and 2011-- for 2 years prior.and I didn't have any comorbids. I was so upset---

2010-5ft 3in 206lbs 36.5 BMI

2011-5ft 3in 217lbs 36.5 BMI

2012 5ft 3in 226 40.0 BMI

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Then to come to find out the doctors didn't get my correct weight for 2010 which was 5ft 3 in 230-- 40.0 BMI---

They are sending in an appeal and I hope they approve this go around but the doctors office still thinks they will not since 2011 was not a BMI of 40

Can you Appeal for the 3rd time around -- does anyone know? It just makes me upset that i'm considered overweight either way- and i'm just a few points away on the BMI scale last year to be in the approval range- that Just gets me!!

Any Help from any one? thanks

BCBS of NC They did not approve the first time-- with these weights and BMI-- they stated they had to be 40 for 2010 and 2011-- for 2 years prior.and I didn't have any comorbids. I was so upset---

2010-5ft 3in 206lbs 36.5 BMI

2011-5ft 3in 217lbs 36.5 BMI

2012 5ft 3in 226 40.0 BMI

---------------------------------------

Then to come to find out the doctors didn't get my correct weight for 2010 which was 5ft 3 in 230-- 40.0 BMI---

They are sending in an appeal and I hope they approve this go around but the doctors office still thinks they will not since 2011 was not a BMI of 40

Can you Appeal for the 3rd time around -- does anyone know? It just makes me upset that i'm considered overweight either way- and i'm just a few points away on the BMI scale last year to be in the approval range- that Just gets me!!

Any Help from any one? thanks