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Looking for someone with BMI of 35-39 that was approved

I have a BMI of 36-37. I do have other issues ie: stress incontinence, herniated discs, terrible reflux/gerd, joint pain, and depression, so I am praying I will be accepted into a program. I am looking for someone else that has a BMI similar to mine that is further along in this process. Thank you in advance for any help you can offer. Kimberly

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I started with a bmi of 37.4, I also have Type 2 Diabetes, high blood pressure, high cholestoral, this all factored into the approval. One knee with arthritis too. I was approved so fast it made my head spin. I am so glad, I am feeling much better, glucose is dropping and taking less and less medications, just got off blood pressure meds. Good Luck and best wishes.

I was just at 35 BMI with High Blood Pressure and was approved no problems with United Health Care.

Good Luck! :ohmy:

I have Aetna PPO Choice (not HMO) with a BMI of 37, one year ago I did drop to 34 BMI hense I was initially denied. After 6 months and 2 appeals I was finally approved and I got the letter from the insurance company last Friday. I am slightly diabetic but that is it.

You did not mention who your insurance carrier was...just curious?

Good Luck!

Dawn - 39 years old

Corona, CA

Aetna approved for Lap Band 06/11/2008

And waiting for surgery date

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Edited by ocbreeze4u

  • Author

I have Cigna. My appt with my PCP is tomorrow and I am prepared. That is another thing...I am actually worried about "loosing" weight because I am at 35 now. Kimberly

I was denied by Cigna and then approved one week later when my PCP's PA requested a peer-to-peer with the Cigna doctor. Sooo glad I didn't have to go through an appeal. I love my band! Life is good!

  • Author

What was your BMI....why were you denied?? Cigna has been very good to us, but this is an expensive procedure and I can understand them researching it. How long did it take to get a denial? Kimberly

Kimberly, The letter said I was denied because I did not meet the medical necessity requirement: I did not have "type 2 diabetes, serious cardiopulmonary problem, coronary artery disease or pulmonary hyper-tension that have failed to respond to appropriate medical management".

My BMI was 37. I completed all of their requirements. My doctor documented in detail the six month weight loss attempt. Actually I went 7 months just to be sure. I sent in documentation to prove I had been obese for more than one year. (They have changed it since and I think it is 2 years now). Went to the psych doc and have several pulmonary exams. Also went to a registered nutritionist, and 2 lapband nutrition classes, attended 2 lapband seminars and joined a support group so I was very prepared for this.

My PCP wrote a very detailed letter of medical necessity. My co-morbs that were submitted included, joint pain, GERD, hyperlipidemia, migrane headaches, sleep apnea, fatigue, shortness of breath, Vitamin D deficiency. I was still denied.

From the time I submitted the paperwork and got the denial and then the approval, it was about 3 weeks total. Not bad. Just some disappointment when I was denied. (It was actually a lot of disappointment.)

Let us know how it goes with you. I send you good wishes that it all will work out!

Bobbie

Hi, my BMI is 39 and I got my surgery date for August 7th (hooray), BCBS will most likely approve and I will hear from them in a week. Just 4 lbs. to lose before surgery. I may try to lose a tad more if I can. I also have Type 2 diabetes and sleep apnea. With 2 co-morbidities that should do the trick.

My husband is having heart surgery on July 14th, so this will be 3 weeks later. He should be able to drive by then I hope, otherwise my daughter can drive me to the hospital and home.

I am so excited......I just hope all goes well with hubby and me

  • 5 months later...

I have a BMI of 36 and have High Blood pressure,Gerd,hyperlipidemia, I have done all my test with my doctor and the 6th month diet.I have Cigna OAP what do you think my chances are for being approved?

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