Ok so I just attended the information session yesterday and I'm pretty much ready to do it like yesterday but my insurance requires 4 or 6 month supervised diet (wasn't very clear) . My question is since My BMI is 41 so I'm borderline meeting the requirement if I lose weight on the 4 or 6 month supervised diet and it drops under the 40 BMI requirement will that mean that I no longer qualify? Do they just use your initial BMI when they submit to insurance or do they use your BMI from your last nutritionist appt?

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I just did not loose weight on my supervised diet. which was ok too. I had Federal BCBS.

do you have comorbidities?

My surgery center said it was based on your bmi on your initial visit. Check with yours to see though.

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My coordinator told me that the first weight matters only, so make your your extra heavy your first consultation. That being said your surgeon or coordinator will tell you whether or not your insurance will be affected if you go under 40 BMI so be sure to ask!

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My initial weight was used.

Thank you all. I have my first consultation June 22 and then my first NUT appt on June 27. I'll make sure to ask

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My office said that I didn't need to lose any weight during the 3 month period. Maybe it is insurance dependent.

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As per my doctors office, in order to qualify, I need to maintain a bmi of 40 and above. If I go below that then the requirements change. The best bet is to call your insurance and verify with them, is it 4 months, or 6? Is it the initial visit? of the last? I work in a hospital and I deal with insurance companies to obtain pre-authorizations for procedure and I can tell you they will deny, deny, deny for the littlest, dumbest sh!t.

My Dr said initial weight but my insurance said do not drop below 40 BMI

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Ok so I just attended the information session yesterday and I'm pretty much ready to do it like yesterday but my insurance requires 4 or 6 month supervised diet (wasn't very clear) . My question is since My BMI is 41 so I'm borderline meeting the requirement if I lose weight on the 4 or 6 month supervised diet and it drops under the 40 BMI requirement will that mean that I no longer qualify? Do they just use your initial BMI when they submit to insurance or do they use your BMI from your last nutritionist appt?

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Make sure to ask this specific question to not only your bariatric center but also your insurance company.....because it is different for different plans. as you've seen in the previous answers sometime just the initial weight is used....but for me every single weigh in counted until they finally submitted to my insurance for approval.....I was like you and started out with a BMI of around 41 and I had to make sure I did not drop below 40 prior to being submitted to my insurance.

My coordinator told me they use the weight after the supervised diet to supply to insurance for approval. She told me not to lose more than 30 pounds during this time or I would be under the 40 bmi.

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My surgeon said its your weight at time of consult with him... To me that makes sense, if your on a diet your going to drop some weight most likely... Most obese people have little problem dropping weight, it's keeping it off that's the problem.... The insurance thing is the most frustrating part of the journey, we have a disease and were left wondering if we will be approved for treatment... It's just so wrong!!!

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

Edited June 5, 201610 yr by nyteacher125

It's so messed up we have to keep fat to be approved. So sad

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