Approval with a BMI of 32?

[Sarahgirl10 1]

Hello, I was wondering if anyone in TX has been approved for the gastric sleeve with a BMI of 32? Since getting injured and being on depression & anxiety medication, I’ve gained 50 lbs in a year. I’ve always have difficulty losing weight, and I’m growing more concerned with the large weight gain + my families medical history of diabetes, heart disease, hypertension, etc.

I don’t have an medical diagnosis other then endometriosis, pcos, & chronic depression so I can’t imagine insurance is going to cover me - which is okay I guess.

I’m just looking for a way to get help because I feel like my health is spiraling.

[ShoppGirl 3,443]

The lowest I have ever heard of insurance covering is 35 BMI with co morbid medical issues. Every insurance is different though. I do know that they give discounts to people who do private pay, though so don’t rule it out entirely if your insurance won’t cover it.

[Sarahgirl10 1]

On 05/26/2021 at 19:30, ShoppGirl said:

The lowest I have ever heard of insurance covering is 35 BMI with co morbid medical issues. Every insurance is different though. I do know that they give discounts to people who do private pay, though so don’t rule it out entirely if your insurance won’t cover it.

I didn’t figure insurance would cover it. I guess my question was more would a surgeon agree to do it with self pay?

[ShoppGirl 3,443]

3 minutes ago, Sarahgirl10 said:

I didn’t figure insurance would cover it. I guess my question was more would a surgeon agree to do it with self pay?

I have heard of people with as low as a 30 BMI getting it approved with things like joint pain. Not personally, just on chats such as this one.

Edited May 27, 2021 by ShoppGirl

[Sarahgirl10 1]

On 05/26/2021 at 19:52, ShoppGirl said:

I have heard of people with as low as a 30 BMI getting it approved with things like joint pain. Not personally, just on chats such as this one.

Awesome. I definitely have joint & chronic pain. A lot of my depression is based around my weight too. Thanks for your input!

[lunadreams 22]

My endocrinologist told me that people with lower BMIs may be covered, but only if there is a serious medical issue.

[Luna Girl 307]

My BMI was 36.7 and my insurance covered it. I did have high bp and high cholesterol though. I was actually surprised insurance covered. I made the decision to have the surgery and was going to be self pay. The drs office insurance coordinator said they would submit to my insurance with the letter from my pcp who recommended the surgery based on family history. One week later, I was approved. It does not hurt to submit to insurance to see if they will cover. You never know. And if your pcp submits a recommendation, that may help. Good Luck!

[floridagirl23 3]

If you don't qualify for the VSG due to your BMI then I would suggest looking into ESG since it is for people with lower BMI's. However, ESG is typically not covered by a lot of insurance plans.