Jump to content
×
Are you looking for the BariatricPal Store? Go now!

All for nothing?



Recommended Posts

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?

Share this post


Link to post
Share on other sites

My insurance only asked for a starting weight

Share this post


Link to post
Share on other sites

Your surgeon will make sure that you meet all of your requirements before they submit your package to your insurance provider

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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. 🤷‍♀️

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×