Anyone ever been denied for BMI being TOO high?
I was talking to a lady the other day in my surgeon's waiting room and she said her insurance denied her based on her BMI being over 50. She was hoping to have the sleeve procedure and I guess her insurance (BCBS of SC) denied her for her BMI being too high. The real kicker was that her BMI was only 52!!
Anyone have BCBS of SC or know of anyone having insurance with a BMI limit for the sleeve? How about anyone being denied with their BMI being slightly over the "limit"??
Just curious.
Ginger
Anyone have BCBS of SC or know of anyone having insurance with a BMI limit for the sleeve? How about anyone being denied with their BMI being slightly over the "limit"??
Just curious.
Ginger
the start of my brand new life was on 5/28/10
On March 22, 2011 at 10:27 PM Pacific Time, sleeve genie wrote:
Did you have to lose weight first, and go to classes? Just curious, you have done an amazing job. You are truly inspirational, love your posts :o) Jeani
JIMBO... 350lbs! lost!..... TRIPLE CENTURY CLUB!! HELL ...YEAH!
MY VSG......KICKS ASS! 
I am 6' 2" 
So did your insurance (BS of CA) have something stating your bmi couldn't be above a certain %? If so, what was the limit?
That just seems NUTS to me. Ummm you would think that BECAUSE your weight was so high, thus your BMI being higher, that you would NEED the surgery more. As I understand it, they set limits because insurance companies think that you may not lose enough through certain surgeries.
Just thought the whole conversation was interesting. My suggestion to her was to try her hardest to lose the 20lbs her insurance was saying she was over by and resubmit OR appeal. She said she was going to just self pay. That wouldn't be an option for me.
Ginger
That just seems NUTS to me. Ummm you would think that BECAUSE your weight was so high, thus your BMI being higher, that you would NEED the surgery more. As I understand it, they set limits because insurance companies think that you may not lose enough through certain surgeries.
Just thought the whole conversation was interesting. My suggestion to her was to try her hardest to lose the 20lbs her insurance was saying she was over by and resubmit OR appeal. She said she was going to just self pay. That wouldn't be an option for me.
Ginger
That's really strange. I've heard of people not having a high enough BMI, but not too high. I think I read somewhere that some surgeons won't perform the lapband on people above a certain BMI because the higher the BMI, the lower your chances of reaching goal with that particular method, but I've never heard of the VSG being denied for it. Considering the VSG started out as a 2 part process for the Duodenal Switch, which is used for high BMI people, I see no reason why a BMI of 52 would be an issue.
FWIW, my BMI is somewhere around there and I've got my initial consult on Thursday. I'll bookmark this thread and will ask my surgeon about BMI restrictions so I can report back with what he says.
FWIW, my BMI is somewhere around there and I've got my initial consult on Thursday. I'll bookmark this thread and will ask my surgeon about BMI restrictions so I can report back with what he says.
Blog | Join me on HealthyWage | Friend me on MyFitnessPal
On March 22, 2011 at 10:29 PM Pacific Time, SpyCbyN8re wrote:
So did your insurance (BS of CA) have something stating your bmi couldn't be above a certain %? If so, what was the limit? That just seems NUTS to me. Ummm you would think that BECAUSE your weight was so high, thus your BMI being higher, that you would NEED the surgery more. As I understand it, they set limits because insurance companies think that you may not lose enough through certain surgeries.
Just thought the whole conversation was interesting. My suggestion to her was to try her hardest to lose the 20lbs her insurance was saying she was over by and resubmit OR appeal. She said she was going to just self pay. That wouldn't be an option for me.
Ginger
JIMBO... 350lbs! lost!..... TRIPLE CENTURY CLUB!! HELL ...YEAH!
MY VSG......KICKS ASS!
I am 6' 2"
Most Active
Recent Topics
