Anyone ever gain weight to get covered by insurance for VSG?

Emberbreeze
on 10/20/11 5:15 am, edited 10/20/11 6:05 am
VSG on 04/04/12
I am in a tight spot right now.  My insurance company requires a BMI of 50 to be considered for the VSG and that is the only surgery I am comfortable with getting.  As of right now I have a 48.5ish BMI and would need to gain about 10lbs to reach a 50 BMI.  The first surgeon I went to pretty much told me it's a waste of his time and energy to request insurance to cover a VSG if I don't have a 50 BMI and that if he did put it through he wouldn't appeal if it was denied.  So now i'm looking for a new surgeon, one that will at least try to get me the surgery I am most comfortable with and I am wondering if I should try to gain weight before my first weigh in with the new doctor so I can be covered.  I'm just stressed because I'm so close, yet so far away.  Has anyone had to deal with this before?

P.S. I have Carefirst BlueCross BlueShield of Maryland

HW (306)  SW (294.5) CW (193)

      

knowbetterdobetter
on 10/24/11 4:50 am - FL
RNY on 03/26/12
I would listen to your first surgeon and not request the insurance to cover your surgery because they will deny it and you will have to go through the appeals process. Ten pounds is not a lot of weight to gain for the surgery you want. Gain the 10 pounds and then see a surgeon. You want to make sure you do everything to get approved the first time because depending on your insurance the appeal process can be brutal. I haven't had my surgery yet but I have worked in health insurance for many years and believe me, they are not going to pay for something that they don't have to pay for. 
PkSteph
on 1/3/12 2:29 am
It's 50 with or without co-morbidities? 
    
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