Losing too much weight BEFORE surgery??

[Luna805 69]

Hey guys!
Question for all:
Can you lose too much weight during the insurance mandated weight loss? Meaning, if my BMI was 41 and then 6 months later it falls below 40... can I disqualify myself? I have BCBS PPO insurance in CA. During this Covid lock down, I stopped eating out and I’m dropping weight. Not a crazy amount but I’m somewhat afraid to tell them I’ve lost 15lbs because it’ll put me under the 40 BMI. I’m on month 5 and have 1 more left and I’m so close! Just from delays & stress and it being SO hot out, I’ve just naturally dipped down in pounds and I’m just trying to do everything right to qualify.

[catwoman7 10,844]

most companies use your starting BMI - but I don't want to say yours will in case they're one of the minority that doesn't. You could always call them and ask. Or your bariatric clinic might know if they've dealt with that company before.

[AZhiker 2,251]

I have BCBS also, and you have to read the requirements very carefully. They basically require 6 months of monitored weight loss plan, documented every month by the PCP. Failure to be able to lose 10% of body weight, in spite of the supervised program is qualifying for surgery. When I first read the requirements, I thought it said I had to LOSE 10% to qualify - to demonstrate compliance with the program, but that;s not what it really says. I think I stayed about the same weight. I was tipping the 40 BMI, but what really helped me was getting a sleep apnea diagnosis, which lowered the qualifying BMI. BCBS is tricky. Just read those requirements over and over until you understand them thoroughly. As long as your PCP also documents all your weight loss attempts very thoroughly, you should not have a problem. My PCP did an amazing job. She knew how to "play the game" and told me she had never had any of her patients denied WLS.

[JessLess 1,163]

My BMI was 40 and my doctor's office said that they would use that number and I didn't need to try to lose weight before...

[JV83 35]

I have united health care ***. My surgery is scheduled for august 31. For my insurance, we had to loose 5 % of body weight. Tomorrow I start a liquid diet and I have to loose another 5 pounds in order to get my surgery. I am doing all this through Sutter health. They encourage weight loss going up to the surgery, the more the better.

[dkpfrog 0]

My insurance only used my starting BMI to qualify me to enter the program.

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