Feeling discouraged after speaking with a doctors receptionist

erinstasey
on 10/24/06 10:09 am
My weight of 202 pounds and a BMI of 33, with high blood pressure, high chloestral, sleep apnea, arthritic back, aches and pains due to weight , I though would make me a canidate for lapband surgery.  I had an appointment for today and found out that doctor was out of network.  Spoke witha receptionist at a doctor in network, who said I could send in paperwork downloaded from their website, but not  having a BMI of 35, doubt I would qualify.  I am so depressed.  I am on so many medications, feel terrible all the time.  I have tried almost any diet you can mention.  Do you think this woman is correct?  I have UHC/EPO.   Thanks,  JoLee
Sean_B
on 10/24/06 11:58 am - Schenectady, NY

She certainly is correct. N.I.H. (National Institutes of Health) guidelines for bariatric surgery are the standards that doctors follow for patient selection....

and insurance companies follow the same guidelines.  So even if the doctor agreed to it, your insurance would never pay for it.

Typically, an acceptable bariatric patient will have a BMI of 40 or higher..... OR... 35 or higher with one or more comorbidities. you have the comorbidities, but not the BMI it's all at NIH.... http://win.niddk.nih.gov/publications/gastric.htm good luck

Pre: 324 Now: 185-190 http://photos-h.ak.fbcdn.net/photos-ak-sf2p/v362/171/99/1251208761/n1251208761_30154298_7588.jpg

Jane M.
on 10/30/06 1:58 am - Williamsburg, VA
Most insurances will not cover any kind of Weightloss Surgery, even Lapband if your BMI is under 40 or 35 with co-morbids. I really doubt that with a BMI of 33 your gonna get approved. Personally, I'd pay out of pocket, then file afterward.
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