Insurance denied revision due to low BMI

jjsmama
on 1/25/11 12:15 pm
 I am seeking a revision from a RNY to a DS. My appeal was denied by my insurance for having a 32 BMI and not a 35. For my height and weight, I am only 8 pounds away.  I would really hate to gain 8 pounds to make it go "goal". Would you do it or what other suggestions does anyone else have. 
Lori P.
on 1/25/11 12:18 pm - Kenosha, WI
Sew weights into your clothing??? 

 



     SW 212 / Goal 130 / Current 130


 

 

Ruthie D.
on 1/25/11 1:05 pm - Mayer, AZ
Do whatcha gotta do if the revision is what you want.  Weighing in winter with thermals and boots helps, as does a roll of quarters in your pocket.  LOL  Good luck!!!
       LIFE'S a REACH...    and then you FLY!!!   
           HW = 224, SW = 204, CW = 124, GW = 119           
Ladytazz
on 1/25/11 1:16 pm
I don't know about you but for me gaining 10 lbs was nothing. It sounds like you are headed there anyway. I would hit a few buffets and that is all it would take.
GreaterFool
on 1/25/11 1:20 pm
Here's the "unpopular" answer:

Perhaps you are not as far away from "normal" as you think?  Perhaps a reallignment of goals and expectations is called for?

Don't kill me.  Just suggesting a dispassionate examination of your situation.

When we were 100, 200, or (as in my case) over 300 pounds overweight, the risks of surgery are very much worthwhile.  When that number is in double digits, it seems reasonable to think about the risks vs. the benefits.

I note you are focussed on how far your are from quallifying for a revision.  How far are you from... not 'goal' weight, but a 'reasonable' weight?  Is your 'goal' realistic?  Reasonable?  Healthy for you?

All worthwhile things to think real hard about.
(deactivated member)
on 1/25/11 7:06 pm - Switzerland
 Thank you for that much needed, "voice of reason".
DebsGiz
on 1/25/11 7:31 pm - FL

As twisted as this sounds, unless you're going to self-pay, you're gonna have to give your insurance company what they want.  Eight more pounds at least... 
Kathleen W.
on 1/25/11 10:27 pm - Lancaster, PA
Along with getting weighed in your regular cloths,  leave your coat and boots on.  Also, you might want to put stuff in your coat pockets like cans of soup, vegies, etc.  Anything that will give you extra weight..  At least afterwards, you'll have lunch handy.  LOL  Sorry,  I couldn't resist.  Snow storms have this effect on me.

SW 327
GW 150
CW 126

                                      

Susan S.
on 1/26/11 12:33 am - Roselle, NJ
I"m with greater fool. You don't qualify for good reason. (Frankly I'm stunned your insurance criteria is a BMI of 35......) Revision to a DS is a very big undertaking and are you sure it's the only path to a healthy achievable weight? I've met a few people who sought revisions.....know two who are two years out from revision who had their initial surgery around the time I did. Guess what......no magic. Susan
Obesity Help Support Group Leader - The Woman Warrior
286/170/131 (starting/goal/current)
LBL - 10-30-08, brachioplasty/augmentation 2-26-09, medial thigh lift 3-16-09
Plastics - Dr. Joseph Fodero

 


286/170/140/131 (starting weight/goal/surgeons goal/current)

LBL 10-30-08 - Joseph Fodero
Brachioplasty/Breast Augmentation - 2=24-09


 

jillagin2000
on 1/26/11 10:34 am
I was revised from Band to RNY and UHC denied me as well because their criteria stated "BMI greater than 40 for the past 5 years".  Here's the thing, my BMI did get below 40 when my band was working.  But then it slipped, not an emergent slip but still I was not doing well, and had gained some of my weight back. So, even if her BMI is below 35 she may still reasonably require a weight loss surgery to 1) fix a broken WLS and to 2) prevent regain.  I had to change insurance to get approved.

310/285/164/145
Highest/Surgery #1/Current/GOAL


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