VSG approval for ppl w/BMI under 50???

In short, I was denied for my sleeve b/c my BMI is less than 50 (I know sucks, right). Anyway, my surgeon is working diligently to get this approved for me.
Question:
Has anyone's insurance approve them for VSG with a BMI less than 50? If so, do you have a link to the policy? I plan to use this info in my appeal...

Thanks for any help!!!

Prin

I would like to say two things. 

1)  BMI and VSG approval/denial do NOT go hand in hand.  A a matter of fact, I have NEVER seen any insurance place BMI in a category for WHICH surgery you can have.  They all say you can have surgery if you meet X Y Z...then they go on to say here are your choices. 

2)  I fought my insurance just to get a VSG.  My BMI was a 55.  They did not cover the VSG period.  If I had an 80 BMI...not covered.  I went on appeal all the way to the state and was denied as they found that the carrier did not say no to WLS, just to the procedure of my choice...that is their reasoning...it was a matter of personal choice.

Check again and see exactly WHAT your policy says in regards to WLS and their criteria.  I cannot imagine it says for this procedure you need this BMI. 

And a sidebar to this:  The lower the BMI the better chance you have of making the VSG work..so the theory of your BMI being too low does not hold water ...it may not be enough for those who need to lose a lot more weight as you dont get the added benefit of having malabsorption  I had the RNY on 9/29/08 so I am about 10 months out and have lost 110 lbs.  Could not be happier (well if I had lost it all I would be...LOL)  and I have had no issues...NONE...I love my RNY!!!  If they offer you the RNY...do it ..you wont be disappointed.  My diabetes went away IMMEDIATELY...while in the hospital my levels were perfect and still are!!!

Thanks for your reply Clare

However, my insurance policy specifically states that they will not cover DS or VSG for individuals w/ an BMI under 50! It is very specific...As a matter of fact the denial letter states "The members BMI is less than 50. The Laparascopic Sleeve Gastrectomy cannot be approved." I tatally agree w/ u that  "The lower the BMI the better chance you have of making the VSG work..so the theory of your BMI being too low does not hold water ...it may not be enough for those who need to lose a lot more weight as you dont get the added benefit of having malabsorption." But it's the malabsorption that I am afraid of! 
It doesn't matter what the insurance company says, they haven't met me yet!!! I am going to FIGHT and I thank God that I have a team of a Doctor, a Nurse, and an Insuarance Coordinator that are willing to FIGHT with me. I WILL WIN THIS FIGHT!!!!!
They did offer me RNY or the lapband, but that's all it is an offer because I AM NOT TAKING IT... I will not get RNY or the lapband. It's just not for me! I am happy that RNY is working out for you and for so many others. But I know me, and it WILL NOT work out for me.

I have been fat for quite some time now. A few more months won't  really make a difference, but a lifetime of regret (if I got RNY) will!!!

Good luck hunni!

That absolutely blows my mind...I have seen a lot of medical policies and researched my ass off.  What insurance do you have?  I wonder if they lump them together as the VSG is part one of a staged DS?

Have you posted this on the VSG board?  I think that you should win on appeal.  It actually is oposite world at your insurance company...give the non malabsoptive procedure to only those who would benefit greatly (over 50) from adding in malabsorption.

I too thought that I had to have the VSG..but it did not work out for me.  I was so adamant.  I tuly am grateful that I did not get it.  Life is mysterious and everything happens for a reason.  Good Luck with your appeal!!

lol..."give the non malabsoptive procedure to only those who would benefit greatly (over 50) from adding in malabsorption." IKR

Yes I did post this on the VSG board and I am totally confident that I am going to win this appeal! I don't want to regret anything. I read your blog and it seems that you pretty much was set on RNY before your final answer from the state, right? I am very happy for you that things worked out the way "you wanted" them to. Things always seem better when we get what we want!!! I personally believe that we "speak" our lives. If we speak and believe it, it WILL happen...good or bad!
Thanks for the encouragement and congrats on your 110 lbs loss...whooo hoooo!

Thanks for the congrats.  You know I was so on the fence and wondered which would be the best for me.  I was a bit relieved that they made that "choice" on my behalf...(opposite world again right..??) 

Good Luck to you and I hope you get it.  I still think that the RNY would be great if you dont get it.  I am not vigiliant by any means at supplements etc and my levels are aok at 10 months out.  I think that the malabsorption for me anyways at a 55 BMI is a necessary means to an end. 

God Speed with the appeal and I truly believe whatever happens, happens for a reason.