Weight requirement for Insurance Approval

MeletaG
on 4/18/08 1:18 am, edited 4/18/08 1:20 am
I can't believe that I have to gain weight in order to get the surgery. I fluxuate between 196-204 normally and I am 5'0 (which is another issue as my general PCP has it written down as 5'2  but I have been 5'0 my whole life) and have for he past 8 months with my regular PCP. Insurance called today and said that I was close to the 40 BMI but I did not qualify for the surgery at this point. I don't want to gain more weight that is the whole issue. I have so many medical conditions and my hereditary medical issue that would scare most doctors. I don't want to have a heart attack by gaining more weight. Anyone have any tips on how to get through this and past it and get approval. I believe that they are going to wave the 6 months requirement for nurtrition and exercise since I have had that with my general PCP. Now this really complicates things. I am so impatient. HELP!!!
Jan C.
on 4/18/08 2:22 am - Cedar Creek, MO

at 5 foot tall you only need to weight 205 to have a bmi of 40.....



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JAN COOK

susyalba
on 4/18/08 4:01 am - Overland Park, KS
Jans right !, put some quarters in your pocket, and have your dr re-measure and weigh you, it sounds like the extra 2" in height has screwed you up. p.s it also couldn't hurt to go in when you know your pre-mentrual as you'll probably retain some water to .

 
 

        
Tamara B.
on 4/18/08 4:43 am - southwest, MO
If the 5 pounds up is an issue, you can certainly fight with a letter pleading your case.......I sent 3 pages of medical info to back up my request when trying to get plastics and got approved...when they do not have an exclusion and they WILL clearly cover it but just feel YOU do not qualify you CAN fight and you SHOULD fight.  List you co-morbidities and the family history and the personal history and get your Dr to righ ta letter of need as well. YOU CAN DO IT!!! DO nto give up!!!!!!!
Tami
openRNY 4/04
251/145
Nancy S.
on 4/18/08 9:53 am - Knob Noster, MO
Get your height corrected first of all...and if you have to slouch a little...then slouch a little.  Rolls of quarters weigh a lot...wear your heaviest clothes...most docs only take off 2 pounds for clothes...and right before you go...drink a 32 ounce drink (worth 2 pounds) and eat a HUGE meal...like a double quarter pounder and fries or something.  I know this all sounds so dishonest...but to keep you from doing something because of 5 pounds is pretty silly...good luck!!!


a_manda
on 4/18/08 10:52 am, edited 4/18/08 10:53 am - MO

Gaining another 5lbs isnt going to cause you to have a heart attack. I can understand that you are impatient --- we are all while going thru the process. Instead of thinking about and stressing over whats going wrong and these little complications try to focus on the following. First --- You have insurance that will pay for your surgery. Millions of Americans dont have insurance at all --- I didnt for many years. If I got sick I had to go the free clinic at the health department. Second --- Thousands of obese patients have insurance but their coverage doesnt cover surgery period.  Either they have to quit their jobs to get different coverage, or they pay totally out of pocket for the surgery here in America or they go down to Mexico, because it's cheaper, and still pay out of pocket. Or sadly --- they never get to have the surgery.  Now --- if you open your heart and mind and realize how TRULY LUCKY you actually are then you can also realize gaining 5 lbs to apease your insurance company isnt as big as a crisis as you may think it is. To get thru this surgery and all its takes before and after you have got to have the right attitude. Gaining 5 lbs isnt complicated --- your insurance company has just told you YES you can have this amazing surgery that will totally change your life and health forever. You should be rejoicing right now.  Start enjoying this NOW or you will miss out on a lot of great moments. You are having SURGERY --- it'll change your life forever --- you are one of the lucky ones my dear.  Best of Luck to you/.

348/199/140




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