Jump to content
×
Are you looking for the BariatricPal Store? Go now!

? about qualifying for lapband



Recommended Posts

Hi everyone,

I feel kind of silly coming on here, but didn't really know where to turn. I'm trying to find out how overweight someone has to be to qualify for the lap-band. I know the home page of this website gives you the lap-band calculator, but I thought I could get some better or more real information from actual people who have undergone the surgery or are going through the steps of trying to get approved for the surgery. I am 30 years old and weigh 215 lbs. at 5'5", so I'm about 85 lbs. overweight, no other health issues that I know of.

Thanks for the input!!!

Share this post


Link to post
Share on other sites

it depends on your insurance if you plan to go that way. If not it depends on the surgeon. People are "supposed" to be a certain BMI or higher but many surgeons will disregard this for their fee.

With a BMI of 35.8 you'd qualify for self-pay; and MAY qualify depending on your insurance and if other issues are found.

Share this post


Link to post
Share on other sites

If you are expecting your insurance to cover surgery, call and ask what their requirements are. My best friend had coverage but they required that she have a BMI of at least 37 for 3 years and hers had been that high only for 18 months so they didn't cover her surgery.

Share this post


Link to post
Share on other sites

Many insurance companies require a BMI of 40 or 35 with co-morbidities. If you are self-pay, it is usually the doctor's requirements then. You will need to be tested for co-morbidities either way, I think. Surgeons always want to know what state of health you're in. Good luck. And PS - take it from me - make sure your surgeon is experienced and only does bariatric surgery.

Share this post


Link to post
Share on other sites

Where I live, there are 2 major players in the market and they both offer monthly meeting to people considering the surgery. They both have Q&A periods at the end. If you have this available, I suggest you go and ask yourself. I barely qualified at a BMI of 35 with other medical condition and got that clarified at that meeting.

Share this post


Link to post
Share on other sites

Many many insurance companies, if you're under a 40 BMI, require comorbidities. I'm 5'4, highest weight was 237, but I have high BP, cholesterol, thyroid (goiter), and sleep apnea. And even with all of those, it was only the sleep apnea using a CPAP machine that qualified me. Self-pay, most doctors are pretty liberal about the BMI, but I would think you would still need to be at least a 35. I even gained 10 lbs to make sure I met the weight (which wasn't hard but even my primary car doctor was telling me to weigh in with rolls of quarters in my pockets.)

So first step is to call your insurance company and find out what they require.

Good luck

Trisha

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×