Denied for Realize Band.

Hiya,

I have been waiting patiently to hear back from my insurance company regarding the Realize Band...and I just did today.  I was denied.
The reason is that my BMI is under 40 and I don't have co-morbidities.  That's NOW...not before.  I have been working hard to get down to this weight and I have been much higher (285 at 5'5).

I am so frustrated.

Does anyone have any advice?

I am crushed.

As a rule the docs submit your pre-weight loss weight to insurance rather than your current weight. Try appealing and use the former weight instead of your weight now. Good luck.

Before appealing, make sure you know your State's laws regarding appeals. Example, in NJ: you can only appeal 3 times. If denied all 3 times, you cannot appeal any longer, and you're "prohibited" to have the operation with that insurance company FOREVER.

My advice, double check your information!! 

(Read between the lines):

You may be SHORTER than what was written down. Example: at 5'5 the "cut off" BMI is 239 (that's a BMI of 39.8). At the same weight a person who is 5'4 has a BMI of 41.0 and 5'3 it's 42.3. So again, you may be SHORTER then you thought (or what was written down).

I've also know people who after denials had themselves weighed again by the Doctor. (Keep reading between the lines). If you this, make sure you don't have extra WEIGHTS in your pockets because that could make you heavier!! One person I know had an extra 10 pound weight in their pocket, and they didn't realize it until the got home. Imagine their suprise.

Hope this was helpful.

Good luck!!!

 Thank you. :)

I imagine they did not look at my presurical weights. 

I also assume that insurance wants to make this as difficult as possible, so they don't have to pay.

 Thank you all so much for the advice.

Funny thing, I am actually 5'4, and my last weight was 236....with clothes on.  And maybe I forgot to emtpy my pockets.

Regardless, surgery for sure on the 16th.  I am both excited and nervous!

GREAT NEWS!!! GLAD TO SEE YOU WERE APPROVED!!

KEEP US POSTED HOW THINGS GO!!

What a wonderful Holiday gift!!

 Thank you. :)
I am excited...and still nervous.

I hope I'll be able to eat everything I eat now, just a lot less of it.

Especially sushi!

You will have to give up some food groups like rice (sushi), pasta, and bread as your nutritionist will explain.  Congrats, however, as you start your journey.  Best of luck!

 Feeling a lot better this morning, it went easier than I thought it would. :)