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All for nothing?

Just starting my journey. Had my first apt on the first with my surgeon, having my endoscopy on the 22nd, my nutritionist apt the 9th. .l also have been on a dr supervised weight loss program for close to 2 years now which she is currently writing up a paper to submit stating why she feels I’m a good candidate as well. My paperwork is coming together... but however, I’m just really thinking this is going to all be for nothing because insurance will deny me. I think it states I have to be with a BMI of 35+ for at least a year and I think I was at a BMI of 34 around nov before it started to go up.... not sure if that’s where they might snag me if they ask for records first? I’m barely squeaking by with BMI even though I have severe hypertension and need a knee replacement. I have my insurance requirements printed out and I’m trying to make sure I line all my ducks in a row but I can’t shakethis feeling they’ll snag me somewhere... anyone have an issue getting approved when they were on the lower BMI side?

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  • Mountaineer514
    Mountaineer514

    Just stay on track with appointments and think positive! You may be worrying over something that won't happen! Good luck.

  • FindingMeWithin
    FindingMeWithin

    I too had an issue at one of my clinic appointments where I fell under 35. They were like if this stays here you wont meet the eligibility guide lines. I panicked as well after all the preop things I

  • That would be a huge sigh of relief if that’s the case! It’s just torture just having to wait well over a month before I can even find out if I’ll be approved!

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My insurance only asked for a starting weight

That's just the worry talking. My insurance only asked for my current weight. Take a deep breath and everything's going to be okay.

  • Author
Thanks guys! It’s torture going through all of this before you even know if you will actually get it! Your positive vibes are much appreciated!

My insurance only wanted the weight I was on my first appointment. I was at 135 bmi with a lot of comorbidities. I was worried about that low BMI as well. Particularly since I wanted to lose as much as I could before the actual surgery so I'd have less to lose afterwards. I was at 132 BMI on the day of surgery and until they rolled me into surgery, completely worried that someone would say "nope, stop, she has lost too much weight" but I worried for nothing.

I too had an issue at one of my clinic appointments where I fell under 35. They were like if this stays here you wont meet the eligibility guide lines. I panicked as well after all the preop things I had done. I needed like 2 pounds to be back where I was. I had to also send in 2 years of Doctor checkups. Some of which were close but not 35. I have 4 comorbitities against me. Too say I was worried was an understatement. Finally,insurance approval came in.

  • Author

That’s awesome they approved you and it’s ridiculous how much you have to worry to get the approval. I just met with the Bariatric nutritionist this past sat. She made me feel better saying she knows my surgeon and she knows he is good at getting people approved and feels I would have no issues but also not to lose any weight right now or gain.. I need to focus on maintaining this until limbo and if approved see if my surgeon does a pre op diet to shrink liver. ?‍♀️

I believe they don't count your BMI during your supervised medical weight loss. It was a huge worry for me before surgery that I would lose to much on my supervised medical weight loss and no longer qualify for the surgery. They explained that it went by my weight before the diet and my falling below wouldn't disqualify me.

  • Author

That would be a huge sigh of relief if that’s the case! It’s just torture just having to wait well over a month before I can even find out if I’ll be approved!

YOUR 'co-morbidity' issues should qualify you. your surgeon will make sure you meet the specs. Chin up!

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