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Reasons to be denied surgery?



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I have my consult with a surgeon next week and was just curious if anyone had experienced being denied for outrageous or really unexpected reasons?

To give you a quick background on myself, I am a 24 year old female who has struggled with my weight since I was 10 years old. I do not smoke and recently had bloodwork done confirming I have elevated cholesterol levels (not to the point of being considered a risk). I have a BMI of 47 and currently sit at 310 lbs on a 5"8 frame. I do not have diabetes or heart-related issues. In essence I meet all the criteria. I have the finances for the surgery already covered and looked after (so I know that is one thing they wont say no about)

From my own research, I can see no reason to be denied, but I have this awful fear that the surgeon will tell me no. Has anyone, who is similar in health condition and meets the criteria for surgery been denied? If so, please let me know. I dont think I could take hearing no from the surgeon when I know this is the path I must follow.

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There are reasons to be "denied" that relate to insurance, and then reasons to be denied that are medical. I'll share with you a saying my granny used to say "Don't borrow trouble". Which means, don't worry about it unless you need to.

No, most people do NOT get denied for "outrageous" reasons. If you meet your insurance criterion and do not have a disease you didn't disclose, why would you be denied? No surgeon will deny you "on a whim".

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I think the general rule of thumb for the lapband procedure is that if you have a BMI less than 40 (but higher than 35) you need to have at least one accompaning weight related health issue (as per the official lapband website: http://www.lapband.com/get_informed/about_lapband/right_for_me/). As I havent had my consultation yet and my own cholesterol has not reached the high risk category, I honestly cant give you an answer on whether cholesterol counts as such. I will keep it in mind for when I have my consultation though and will post my surgeon's answer here. It would be silly not to consider high colesterol as a comorbidity of obesity, but I am not the professional in this field :tongue_smilie:

Edited by Juwel

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Is high cholesterol a reason to be given an exception to the 40 BMI rule?

That would depend totally on what your insurance requires.

Many policies differ about what they require before they'll pay for the lap band procedure.

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