Proof of BMI at or above 40 for 5 years?

Rocco3369
on 5/5/17 9:40 pm

I know each insurance company is different but is it a standard to prove BMI at or above 40 for 5 years? My weight has gone up and down so not always a BMI of 40.

Also, I have a sleep test coming up (my PCP recommend it due to snoring) but I really don't think I have sleep apnea. If go through with the sleep study and am found not to have it could that hurt my chance of being approved? I do not have high blood pressure or diabetes.

Mostly what documents I have are Dr. weigh ins and a high BMI. Am I still a candidate?

(deactivated member)
on 5/5/17 11:30 pm
Cathy H.
on 5/6/17 2:34 am
VSG on 10/31/16

Actually many insurances want BMI or weight history for 5 years to show you have had an ongoing weight issue and not just seeking surgery on a whim.

Livin' La KETO Loca!!
134 lbs lost since surgery, 195 overall!! Initial goal reached 9/15/17, (10.5 months)!
5'3", SW*: 299 GW: 175 HW 3/2015: 360 PSW* 5/2016: 330 *PSW=Prog Start Wt; SW=Surgery Wt

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Rocco3369
on 5/6/17 10:50 pm

I have only had health insurance for the last 3 years. Do you happen to know how or what I can use as documentation for the 2 years without insurance coverage?

Thank you for your reply.

Gwen M.
on 5/6/17 6:31 am
VSG on 03/13/14

Actually, no, these are nothing alike.

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

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hollykim
on 5/6/17 8:07 am - Nashville, TN
Revision on 03/18/15
On May 6, 2017 at 6:30 AM Pacific Time, jmm1234 wrote:

No such requirement, someone is giving you bad info. It would be like saying you have to prove you've had cancer for at least five years before you can get treatment.

this is incorrect info you are giving. Many insurance companies have this requirement. They can require anything they like before coverage.

 


          

 

ChristineB
on 5/7/17 1:41 am - Western 'Burbs Chgo, IL
On May 6, 2017 at 6:30 AM Pacific Time, jmm1234 wrote:

No such requirement, someone is giving you bad info. It would be like saying you have to prove you've had cancer for at least five years before you can get treatment.

Sorry, you are incorrect. It all depends on the person's policy. My husband and sister both had similar requirements with 2 different ins companies.

 
Open RNY May 7
260/155/140 




 

(deactivated member)
on 5/7/17 11:01 pm
Grim_Traveller
on 5/8/17 3:52 pm
RNY on 08/21/12

Most insurance companies that have this requirement will not take your word for it. And they will not accept a summary letter from your doctor. They want the actual medical records. And no doctor is going to falsify a medical record just to help you qualify.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

Sparklekitty, Science-Loving Derby Hag
on 5/12/17 9:54 am
RNY on 08/05/19

Yes, it WOULD be ridiculous to expect a formal weight history for the sole purpose of WLS approval.

It would NOT be ridiculous to hope that someone had been in for a checkup, blood work, sinus infection, or other random medical complaint (with accompanying weigh-in as standard visit procedure) each year.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

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