Getting denied by insurance because of weight loss ?

I have a question for you guys ! I'm currently in the process of getting a VSG . My doctor referred me to a bariatric surgeon and dietician. My 6 months monitored diet that the insurance requires starts pretty much today . I have been documented as 284 pounds as my starting weight which puts me at a BMI of 42.5 . The thing is , I have lost 21 pounds since May of this year . So my BMI is decreasing pretty good .

My question is , since my insurance requires a BMI of 40+ , will I become disqualified if I loose more weight ( which I plan on ) and my BMI reaches the 30-39.9 percentile ? I don't want to loose so much it disqualifies me

Your recorded weight on the first visit is the one normally used. Call the number on the back of your insurance card to check

As mentioned it is important that you check with your insurance company. I was lucky and mine used starting weight (I also had a 6 month required supervised weight loss period), but not all do.

I've seen people get denied for losing, but usually they go by your starting weight.

If it were me, I would also talk to your surgeons office. If it is a big group, they will have an employee who only does insurance work. The insurance company doesn't know what you weigh, they only know what the surgeons office tells them. Ask the office if they only submit the starting weight, or a final pre surgery weight.

When you get approved by the insurance company for surgery, get it in writing, and keep a copy of it.

That is great information thankyou so much and wow that is an amazing weight loss ! Such an inspiration .

My surgeon told me I could be denied if I went too low. He and the dietitian both quietly and off the record advised me to follow the pre-op diet but not go below the weight needed to qualify for surgery.

I would have a conversation with your insurance company and get the answers in writing. My insurance also assigned a bariateic nurse to monitor and document during my 6 month "waiting" period which was great for getting through the final hoops.

I'm 5'2.5" and was told not to go under 190 or the surgery would not be done. But the day of the pre op and the day of the surgery no one weighed me.

I was weighed on both of those days.

My VSG was dependent on my pre admission test weight. I had to really pull in the reins and did that final weigh in with heavy shoes and clothes and made it within a pound.