If You Had To Gain Weight to Get Lap-Band Covered By Insurance...?

[Emilysgigi 3]

I gained 3#'s to make the 40 BMI. I didn't think about it at the time, but drinking a lot of Water and wearing heavy clothes probably would have got me the 3#'s.

[teeniebeenie79 0]

I went origionally for my consult on Jan 4. I was 12 lbs under. My nurse told me to go out and have a few good meals and come back...so I did and I was perfectly at a BMI of 40.3! They are now getting everything ready for me, and I have to do 3 mos of the dieting, but then we will be good to go!

[anniedub 0]

Damn. I'm so glad I didn't have to play games like you guys!

My heaviest weight was 100 kg (220 lbs) and on the day I saw the surgeon I was 96 (209 lbs). I was worried that he wouldn't accept me as a patient because I was too light! (I'm 5'3'). But he said he has used the lap band on people who weighed 75 kg (165 lbs). So I was never going to have a problem!

Still, you're pretty lucky if you can get insurance to pay for your surgery. Here in Australia, even top-notch insurance will only cover some of it. I have top of the line insurance, and my procedure still cost me $6500 AUD (around $6200 US dollars). Without insurance you're looking at $20,000 AUD (around $19,000 US).

You guys can get this fully paid by insurance? Damn. Thats brilliant. Thats worth gaining 100 pounds for.

[Frustrated 1]

Damn. I'm so glad I didn't have to play games like you guys!

My heaviest weight was 100 kg (220 lbs) and on the day I saw the surgeon I was 96 (209 lbs). I was worried that he wouldn't accept me as a patient because I was too light! (I'm 5'3'). But he said he has used the lap band on people who weighed 75 kg (165 lbs). So I was never going to have a problem!

Still, you're pretty lucky if you can get insurance to pay for your surgery. Here in Australia, even top-notch insurance will only cover some of it. I have top of the line insurance, and my procedure still cost me $6500 AUD (around $6200 US dollars). Without insurance you're looking at $20,000 AUD (around $19,000 US).

You guys can get this fully paid by insurance? Damn. Thats brilliant. Thats worth gaining 100 pounds for.

I didn't get mine fully paid by insurance. There was an 80% coverage. It still cost me $4,200. I've heard of some that have managed to get 100% coverage. But there are a lot of people who have paid for it themselves here. And some of them have traveled to Mexico for the procedure because the air fair, accommodation and surgery in total end up being significantly cheaper.

[anniedub 0]

I didn't get mine fully paid by insurance. There was an 80% coverage. It still cost me $4,200. I've heard of some that have managed to get 100% coverage.

Phew! I was about to run a riot to my insurance company! Something along the lines of "We keep hearing that American health insurance is a crock, and yet they can still get free lap-band surgery???" :eek:

Thanks for clearing that up! :grouphug:

[Kwlvjs99 0]

I admit!!! I gained 20lbs to qualify.. I wanted to make sure my BMI was 40!!!!!

[lori0307 0]

I did it!!! I was 20 pounds shy of having my bmi at 40. It was only 36. I did the math and figured out that if I gained 20 pounds, my insurance would cover it. That was well worth it for me. I don't have an extra $14K laying around to self pay. I was able to gain about 10 pounds by eating whatever I wanted but I couldn't gain the whole 20. So I used the ankle weights. I took out the individual packets of weights and distributed them all over my body. In my pockets, in my bra, I even sewed some into the t-shirt I was wearing under my sweatshirt. Oh and I also scrunched down to get my height measured. I slumped off about an inch and a half. There are tricks and they worked for me. I finally go approved 3 weeks ago after fighting with insurance for almost a year. My surgery is March 27!!!!

[MacMadame 81]

I plan to slump when my height gets measured. I was, as a 20-something, 5' 1.75" and then after my first kid I was 5' 1.25" and then after the second kid I was 5" .75" which would always get written down as 5" but about 6 months ago I got my height measured at the doctor's office and I was back to 5' 1.25" and they now write it down as 5' 1" and that is JUST NOT FAIR!

[losing it in ne 0]

what a hoot. I needed to lose 75lbs to quailify for lab band with my insurance guidelines. Medically I can't safely have a bypass which I really didn't want. The insurance has since :thumbup:lifted the restriction and I have my surgery Apr 10

[Truckerbabe2000 0]

I'm waiting to be approved by insurance. When approved my only cost will be $150.00. Fills will be $15.00. Wish me luck!

[gkeyt 0]

This is funny. I had the same dilemma. My doc didn't come out and tell me how to "work it" but they did round my height "down" to 5'3" (I am 5'3.75" and usually it gets rounded up). I asked what would happen if I lost any weight before surgery, since I was right on the line of 40 when I had my last appt before surgery. He said they base the approval on the letter he wrote with all my insurance paperwork, and it wouldn't matter. He also said, "Just don't lose much weight before then," which I thought was funny since that was why I was there!! But I was afraid that if my BMI was too low when they weighed me on the day of surgery, my insurance would change their mind! I have no idea if that would have happened or not, but I was pretty paranoid.

The BMI game is so dumb, anyway. Why am I so much healthier at 39.9 that I no longer require WLS, when at 40 I am MO and need surgery? Doesn't make sense. Anyway, in the months between my first appointment and my surgery (about 2 1/2 months) I just ate without regard for losing weight. I did gain weight, and my insurance paid for my surgery. It's so silly to me because it doesn't change our need for the surgery. How the weight fluctuates in the month before surgery isn't a reflection on what has gone on for the past several years. But still, they make us play the game.

[moonshadow2468 0]

I put led fishing weights in my pockets, I also slumped when they took my height, that made my BMI higher.

[anjelinaj 0]

I am all set for my first consult to get the band. I am nervous, but excited. I am worried about the BMI and insurance question, though. I am right on 40 now, but my insurance is requiring me to go back to my surgeon once a month for 6 months. I would hope to lose some during this time, but am afraid my insurance will deny me if I drop below the required 40. Anyone with similar insurance requirements??

[Kat817 19]

Wear your heaviest clothes, and drink lots before your first appointment--then if you have a rough patch, it will not show up as a gain!

Many women tend to carry extra weight during TOM--so give yourself a few pounds insurance.

Myself, I was plenty heavy enough--but I would not have hesitated to help things along!!

Kat

[anjelinaj 0]

LMAO!! My appt is in JUNE of course. Jeans will probably be the heaviest thing I could get by with without raising eyebrows. It will be hard to remember not to take out keys, cell phone, shoes-I'm used to trying to ditch anything that might make the scale go up!