Under BMI

[momofthree1986 12]

So once you are approved for the surgery through your insurance of you drop below the 40 BMI after the pre op diet they will still do the surgery??

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[KristenLe 5,979]

So once you are approved for the surgery through your insurance of you drop below the 40 BMI after the pre op diet they will still do the surgery??

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Yes. There's only been one or two people that indicated they couldn't lose before surgery but I think that was because BMI right at 35. I'm much fatter than a 40 BMI so I never had to worry (only benefit of being morbidly obese I think)! Lol

[MickiinFL 14]

You may only need a BMI of 35 with 2 comorbidities, high blood pressure, cholesterol, sleep apnea etc...

Edited September 9, 2016 by MickiinFL

[katie09/21/2016 137]

So once you are approved for the surgery through your insurance of you drop below the 40 BMI after the pre op diet they will still do the surgery??

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I am having surgery on the 21st of September & I have lost 50 pounds since my initial weigh in. My insurance required weightloss every single month for 6 months (weighing in once a month). If you gain weight or don't lose the 6 months starts over!! This didn't happen to me but I know other people who had to start over.

At my initial weigh in my BMI was JUST 40. My current BMI is 33...it will probably drop down another point before surgery because of the clear liquid diet I'm currently on.

So for me, it was just the very first weigh in that I needed to have a BMI of 40 (I have no health probs or it would be 35) for insurance approval. Every other weigh in I was required to lose weight.

I am with united healthcare and with approval they are covering 80% of my gastric sleeve surgery. I will be out of pocket around $2600 but I knew that before the approval so we planned for it.

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[laceemouse 631]

So once you are approved for the surgery through your insurance of you drop below the 40 BMI after the pre op diet they will still do the surgery??

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It depends on your insurance. I was right at BMI 40 when I went to my doctor early August. They sent me to a psych eval and after they get that report they are going to submit to insurance. I am sure I have fluctuated up and down since then but it doesn't matter. Once I am approved they aren't going to cancel my surgery if I lose a couple of pounds. I am not trying to lose not but I know I will on the pre-op diet. My surgeon only does 3 days of liquid diet pre-op but I know I will lose a couple of pounds doing that.

Some insurance companies require several months of being a high enough BMI, some require you to lose before surgery, they are all so different. And then of course lots of people pay out-of-pocket for surgery. I considered that when I wasn't quite BMI 40.

[KristenLe 5,979]

@@momofthree1986 Measure your height - someone on another post just went from not qualifying to qualifying because her she was shorter than she originally thought! :-)

[Alex Brecher 10,495]

@@momofthree1986,

I would see what your surgeon says. You might have a comorbidity that you are unaware of. It might not be a comorbidity that is currently life-threatening – it could be something like high cholesterol. Something like joint pain that prevents you from doing everything you want to do might count, too.

Have you checked your insurance policy to see what the requirements are to cover surgery?

Good luck with your consult and your WLS journey!

[momofthree1986 12]

I actually just remeasured myself and I am 5ft 2" lol

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[laceemouse 631]

I actually just remeasured myself and I am 5ft 2" lol

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Is that shorter than you thought you were? Maybe check your BMI again??

[Armygalbonnie 643]

I'm at 35.2 BMI. I do have a co-morbidity. Surgery won't be until November. My NUT told me they will weigh me on the day of surgery. If I'm below 35, they will cancel the surgery, right then-and-there. This is stressful! I hope they will weigh me with my clothes on. Definitely a question I'm going to ask at my last NUT visit in 3 weeks.

[Social Introvert 28]

I read this title and chuckled to myself a little because I tried and failed to gain weight to reach a 40 BMI a few years back! Y'all...that was the hardest thing in the world for me! I was at like a 37-38 and only needed to gain about 15 pounds. I could not move past 220 which was about 10 pounds short! That was very frustrating. I still haven't made it to 40! But I'm going to press on and just do self pay in Mexico! I refuse to let insurance dictate whether or not I have surgery.

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[katie09/21/2016 137]

I'm at 35.2 BMI. I do have a co-morbidity. Surgery won't be until November. My NUT told me they will weigh me on the day of surgery. If I'm below 35, they will cancel the surgery, right then-and-there. This is stressful! I hope they will weigh me with my clothes on. Definitely a question I'm going to ask at my last NUT visit in 3 weeks.

I wonder why they would cancel they surgery if your BMI drops below 35? Did they give you a reason? My surgeon wanted me to lose as much weight as possible before surgery. I had a BMI of 40 when I started the medically supervised weightloss and as of this morning my BMI is 32 - my surgery is next week. Everyone's process is so different

I've heard a few people say the same as you, they can't drop below 35.

Goodluck I hope it all works out!

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