Too much weight loss during pre-surgery diet??

I have heard two different answers to this question- both from this board and both from my surgeon's office....

I am pre-surgery dieting and I am at the borderline of going under the required BMI of 40. I was well over it at my first appointment, but now I am getting close (within 2 pounds) and I still have 6 more weeks to go. (I have no other co-morbidities that would help qualify me.)

I have been told going under the 40 BMI is no problem but I have also been told you will be denied for this. Anyone have first hand knowledge of this situation. (BTW - I have Aetna.)

Thanks soo very much!!!

Can you check your insurance policy online, or do you have a hard copy?  I have BCBS and it specifically states that the starting BMI is the one they sure for predetermination.

-Danny

Thank you Danny! That is good advice. I don't think I can see my complete policy online, but I will try to get my hands on a hard copy!!

I have Aetna and they will look at a two year history of your BMI.  Myself and my three kids all were approved with Aetna.  You must show a two year history and within those two years can not dip below the 40 or they will deny.  But once you start the process, they go from your startinig weight.

BTW, you can see their clinical bulletin at www.aetna.com.  Then, in the search box type 0157 and it will bring up clinical bulletin 0157 which is their requirements for bariatric surgery.  or type in bariatric surgery in the search box and it will bring up clinical bulletin 0175.

Good Luck with your approva!

Nan

Aetna will use your beginning BMI not the BMI after your supervised diet

Wow! I've seriously been looking for something about this very question, and happened upon yours! 
                                                                                                                                                                           I'm also insured by Aetna, and I've almost completed my 90 day pre-op requirement.  I'm about 6 lbs away from falling under the required 40 BMI, and asked my nutritionist about it this week.  I've had on again/off again HBP, but never been on anything other than a diuretic to help keep it in check, so I'm pretty sure that won't be looked at as a co-morbidity.  Other than that, I'm pretty healthy, just really obese, and trying to head off some real problems before they blow up.        

I'm sure most people worry about this while waiting on insurance approval.  I'd rather avoid the whole "appeal" process by not falling under 40 BMI!  How weird is that, considering the goal is to LOSE weight?!
 
Anyway, I'd love to hear from you if you get any definitive answers.  And I'll certainly try to look it up online, too. 

Best of luck to you!  I hope you're approved soon and on your way!

BTW, the coordinator at the surgeons office said they only need to submit medical records reflecting a BMI of 40 or higher on a visit in' 09 and a visit in '10.  I was almost consistently that with the exception of 1 visit near the beginning of 09.  She said it wouldn't be a problem at all.  I hope she's right!

I'm also in the same position with Aetna!  I kind of freaked out because I lost about 9 pounds over the first 30 days of the 90 day diet.  Second 30 days I gained 1 pound.  Now I'm partially through the last 30 days and hoping to lose just 3 pounds because any more will put me under 40 bmi.  FWIW, my doc's coordinator said that Aetna will deny if I go under 40 on the diet.  It is driving me crazy trying to manage to be "compliant" yet stay in range.  Additionally, I'm a little concerned that they might not take my 90 day program and require me to do an additional 3 months of diet - in which case how does one ever manage to stay exactly the same over a 3 month period?!  This whole thing is just so stressful...