So my insurance wants me either heavier (BMI 40) or to have very SPECIFIC comorbidities (which I don't have). My BMI is 38.8 but I don't have diabetes or heart disease. My best bet is to pay cash - $13,100. Yeah, I don't just have that kind of cash available.

I'm so disappointed. I started to really wrap my mind around the changes you have to make beforehand, the changes afterward, and now I feel so let down. Stupid insurance. Don't they realize I'm gonna cost them more in the long run if I stay this big or get bigger!!!?

Anyway... I wish everyone else the absolute best. Maybe I'll continue to watch everyone so I can send positive thoughts your way.

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I have Aetna too, but our plan made me have to have a BMI of 50 without any other problems. The surgeon told thee cordinator that she was certain there had to be something else wrong with me. I called my dr and set up an app to get everything checked out to be sure. Turns out I AM diabetic ( which I was not expecting) so I did not have to gain the extra weight and I still have a sleep study coming up to make sure I don't have sleep apnea.

I would say if it's only 7 lbs, maybe just eat crap for a week and see where it gets you... or have your dr check for other issues you either haven't been checked for or recheck to make sure anything hasn't come up, that could help!

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I was in the same situation as you and I'm self paying. My insurance makes it a nightmare to get approved and I am BMI 37. With my insurance they want to see a history of over 40 BMI so I would've had to gain it and keep it on for a while. I don't know if Mexico is an option for you but I looked into it and if my husband hadn't vetoed it I would've gone. Once you do some research there are some really good places but he just heard "surgery" and "Mexico" and assumed the worst.

I am self paying 14.5K but there are surgeons in my area who do it for 11K. My paranoid husband wants me to use this one because they do the BLIS insurance, he's nervous about the whole idea of surgery so I'm giving in, lol. The one thing I will say for self pay is that it is a LOT faster and less hassle. My first appt was August 4th and my surgery is October 11 (and I had to push it back 2 weeks). My appointments and stuff ended up even taking a little longer than most people. Some of the girls in my class were 3 weeks from 1st appt to surgery.

Edited October 4, 20169 yr by julia37

If I could self pay I totally would. Might look into it. Because even if I gain those 7 lbs or so, they're gonna want HISTORY of BMI > 40 won't they? I'm at my heaviest right now (38) and it's plenty heavy believe me!!

So maybe self pay is the way to go

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If I could self pay I totally would. Might look into it. Because even if I gain those 7 lbs or so, they're gonna want HISTORY of BMI > 40 won't they? I'm at my heaviest right now (38) and it's plenty heavy believe me!!

So maybe self pay is the way to go

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I think a lot of that depends on your insurance. I've heard of people just having their one weigh in used but then others who do the 6 month pre op diet and they use that weight and then they can't be covered b/c they lost too much.

Honestly if you can come up with a way to pay for it I would look into it. It's an investment in your health. There will be some savings down the road esp if you eat out a lot or drink a lot of soda, etc. If you smoke or drink then you will have to stop (or mostly stop) and that saves $$ too. If going to Mexico is an option for you it can be less than 5K

I was in this same boat before my surgery! I was like 13lbs away from being able to get approved. So i made another dr's appt about a month out. Ate like a crazy woman during those 4 weeks and bam! Got approved. I was kinda sad I had to eat like crap to get a surgery to where I have to change my lifestyle completely. Seemed like a waste. But hey! I did it and now I am 2 months post op! Good Luck to you, you got this!!

Which insurance do you have?

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The insurance game is a total buzz kill, but unfortunately you have to play their game for approval.. I had to gain weight to qualify, not my proudest moment.. However now being 6 week post op and down 35 pounds, I would do it again in a heart beat..

Good luck

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Thanks everyone. I think that's the route I have to go. As nice as it would be to "just self pay"...I'm a divorced mom of 3 and that kind of money doesn't come easily. I guess I play the insurance game and know that it will all be worth it!!

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My husband has a KILLER fettuccine alfredo recipe. It's pure fat and oh so delicious. Let me know if you want it to help get you to that 40bmi!

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I feel the same. I was accepted for surgery, but so low a BMI, I'm terrified to lose any weight. I keep eating!

I hope insurance accepts you. If they don't, you can have surgery in Mexico for $4500.

My wife's in the same boat you are. She has had to wait to get hers until the summer (she's a teacher) and she has a break with enough time for recovery...she's very jealous of me. But she gained enough to meet the 40 BMI requirement and she's been maintaining at that weight so that when she weighs in at the doctor's office, she has a history of being at 40 BMI. It sucks to have to do, but in this case you have to game the system to get what you need. Insurance companies are the worst.

I wish your wife the best. It's sad we have to find ways to beat the system, often to our own detriment. She's gonna get there. Tell her to keep her chin up.

if you tell them you have sleep apnea theyll do it with a lower bmi. thats what the doc told me. i didnt need to lie my bmi is high. just a thought.

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Most do a sleep study, not just take your word.

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Staceface what insurance do u have?

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