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Being approved for surgery

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I’m 27, 5’4 and 219 pounds. My last known weight before that was 231 but I ended up getting sick and having to have emergency surgery so I lost a bit while in the hospital. I have PCOS, GERD, sleep apnea and fibromyalgia. 4 years ago I lost 90 pounds (from 250) and was down to 160 but with life, stress and kids I’ve gained most of it back. I’ve tried everything this last year and a half to get the weight back off but I’ve been unsuccessful. Would I be a candidate to be approved for surgery even though my BMI isn’t at 40? I have WellCare and I have an appointment for a consultation on March 5th with the surgeon but I’m scared I’ll just be told to keep trying to loose weight myself.

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Most insurances will approve WLS if your BMI is 35 and you have a comorbidity. Documented sleep apnea is usually accepted as a comorbidity, along with diabetes, high blood pressure and hyperlipidemia. Using a BMI calculator I come up with a BMI of 37.6. Along with your sleep apnea, you should qualify. Your surgeon will do what he can to get you approved, he/she wants your business!

OMG I can't believe I'd recommend this to anyone, but if they say your BMI is too low, you only have to get up to 235 lbs to have a BMI of 40.1! But if your insurance is like most of the other ones they'll accept your sleep apnea and a BMI of 37.6

Good luck and keep us posted!

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