Last week I had my visit with dr bauman, he said my BMI was 39.4 and that I didn't qualify because it was under 40. Has anyone else had bmi lower than 40, I do have hypertension and it's treated with medicine. Just curious. Actually, I'm looking for encouragement that I will get approved. THe insurance lady felt that it was worth while sending it in to UHC.

Jennifer

The FDA specifies two co-morbidities under 40 BMI. Hypertension would count and any kind of back or joint paid would count, as well. Go for it!

I was a bmi of 34 and went to self pay in Mexico. There are MANY people here that had their insurance pay with under 40 BMI though. I am sure they will post soon. GOOD LUCK!!!

Thanks. My BMI is so, so close. I only need 1 pound to be at a 40 BMI.

I have two herniated disc's in my back and I believe the back dr was going to write an elaborate letter about how weight loss would help,.

Oh, I worry too much. I'm sure everything will work out.

Jen

Get that letter from the back doc, Jen. Make it easy for them to approve you. Yay!

Jennifer - luckily UHC is probably the most friendly when it comes to wls. The chances of you getting approved are great. Get the letter - and as much other info you can from your primary doc - and have that all submitted. Chances are you will be approved - providing there are no exclusions in your policy about weight loss.

My BMI was 36 when I started this process. My insurance would pay for it - no questions at 40; or they would pay at 35+ with 2 comorbidities. They are VERY strict about the co-morbidities. They have to be documented and diagnosed by a physician.

For example... hyperlipidemia is a comorbidity - so I had my cholesterol checked. It was 236, which is not normal, but my doc said I did not need meds - so that didn't count.

I am not on ANY other meds... no HBP, no diabetes.

sleep Apnea is a comorbidity (which I don't have) but you need a sleep study to document it.

Osteoarthritis is one, but you have to prove it. I went to an orthopedist and he says my knee pain was not OA= that my XRAYS looked great.

The moral of my story ... self pay.

Good luck!!!

Is this your highest weight? If not make sure you have a 5 year weight history from your pcp or gynocologist to help. Even if it is your highest weight I'm betting the weight history would prove that its going up slowly but surely. I mean everyones weights can very a few pounds from day to day. Even from scale to scale. Also get documatation about your back pain from the doctor you saw for that. I don't think you will have a promblem.

Melissa

Thanks for all the responces. i haven't given it enough time , but i Keep thinking about the non-40 BMI issue. I cannot seem to shut it off in my head.

I have so much medical documentation from the PCP, I go all the time, luckily, the 5 years coinsides with the delivery of my daughter, otherwise I'd have to get gyn records too. I have ton's of documentation for my back. I am sure my cholestoral is high too. I just cannot get this off my mind. Plus, I have not finished all my paper work and appointments. I have to go to the psych, dietician, and upper gi process.

Oh yeah, to make matters worse, now is open enrollment for my companies health plan, so the insurance offce at dr bauman's said to keep the same coverage because it covers Lap Band 100%. I also have to factor in the fill's.

I'm off....

Jen

In that situation I wouldnt hesitate to gain a few pounds. Although its easier said than done when you actually try to do it.

My BMI is 35, and most of the info available on the web is American so I thought I'd have to work hard to prove comorbidities. I woudlnt even consider gaining enough weight to put me over 40 (about 14lb), that would be dangerous, but gee, they'd only have to weigh you after Christmas dinner or something and you'd be there. Its not going to harm you to gain 2 or 3 pounds.

If we are only talking about 5-10 lbs, I would gain it too. I wouldn't be happy about it but I guess I would of had a helluva good time at the restraunts trying!

I'm acutally 12 ounces from qualifying at a bmi of 40. If I had weighed one pound more I'd be qualified. I haven't heard back from the dr's office.

I'm anxious to know something. I know it's been a short time since I met them.

I'm going for the rest of my testing in Nov. I know it's just a few weeks away.

I;d like to change my insurance next year but there's no way I would while I'm waiting for approval. DH doens't work so he doesn't have any insurance options for us. Also, I am afraid of being turned down.

Jennifer

Heck only 12 oz...wear heavier clothes and down continueous Water before consult! LOL

Melissa

Yep - Eat salty food the night before and drink lots of Water. That should do it.

:]

When I did weight watchers....weigh in night was always chinese night. As soon as the meeting was over I'd run by and get chinese takout..lol. It took me almost a week it seemed to get over the amount of sodium that was in that MEAL LOL

Melissa

Jen,

I have UHC and am in the same position. My BMI is 38.6 and my co-morbidities are relatively minor: GERD & depression. I have my nutrition & psych evals next Tuesday. I know UHC through my employer covers WLS, but they won't give out details on their criteria. I'm still going to try.

If I get turned down, I'm likely to eat until I hit the 40 BMI mark and try again.

God bless and good luck. Just remember, you're not alone