will they take me???

veronica H.
on 11/3/07 2:45 am - Fairfield, CA
hi there, im 23. 5' nothin, and weigh 230. ive been lurkin around all the forums, and i havnt seen any1 who has started at my weight. im wondering if theres ne out there whos been approved??? my dr sent the refferal to the surgeon (with kaiser) but im nervous that hes gunna tell me no. what do u think??
sadlydemented
on 11/3/07 3:40 am
Your BMI is around 44 so I cah't imagine why they wouldn't take you.  Most insurance companies require a BMI of 40+ to do surgery OR a BMI of 35+ with co-morbids.
veronica H.
on 11/3/07 3:50 am - Fairfield, CA
ok =) cool. i kno ive read that.. i just havnt seen it.. and i heard there gunna make me loose 20 lbs too.. so i was just worried maybe i was cutting it close if i loose the weight.
sadlydemented
on 11/3/07 3:53 am
My insurance and surgeon did not make me lose any weight.  My surgery is on Thursday and they did not make me do any kind of diet.  As long as the BMI sent to the insurance is 40+ you should be fine.  it really depends on your surgeon and insurance so I would give them a call to see what they cover.
Sheesh S.
on 11/3/07 5:42 am
Revision on 07/07/14
I am 5'1.5 and started at 260. When I first applied for surgery I THOUGHT i was 230, But I was wrong... Anyway point is I got approved. Booya


*~*Jaci *.
on 11/3/07 6:11 am - Central Valley, CA
Kaiser does require the 10% weight loss... but there are some that have fought it and approved after fighting because of the low BMI.  If I were you, I'd call Kaiser and ask about the BMI and weight loss requirement. Good luck, hon!

*~*Jaci*~*

The more things the change, the more they're still the same.

Jennifer K.
on 11/3/07 11:42 am - Phoenix , AZ
Girrrrrrrrrrl by the time I got approved for surgery I was 152lbs... and 5'7"... had a good 7 inches on yah and 22lbs!! :-)

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

Jennifer K.
on 11/3/07 11:43 am - Phoenix , AZ
Sorry... 252!!! hahah Ive been in the 100s so long Im use to typing that!

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

jennadweeb
on 11/3/07 2:12 pm
i was just reading a profile yesterday and she waqs 5'2 and 220 and was approved no problem. however it was a different insurance. all i can say is it never hurts to ask.
Michael B.
on 11/3/07 11:14 pm - Gilbert, AZ
You'll have to call Keiser....you're probably fine...every insurance company is different, Although I haven't heard of any of them with a target any higher t han a 40 BMI...I had United Healthcare, there requirements were that the patiient be at a BMI of 40 or above and that I provide a five year weight history - which was just me calling my Primary Care Physician and asking what my highest recorded weight was for the each of the past five years and attaching their contact info in case they wanted to verify it with the doctor's office themselves...It would help if you asked these specific questions: Is morbid obesity a covered benefit in your policy? Give them the ICD9 Code of 278.01. If morbid obesity is a covered benefit, check that the operative procedure you are considering is also covered. For the Roux-en-Y procedure give them the CPT Code of 43846 or 43644 and for the Lap-Band® Procedure give them the CPT Code of: 43659 .It's crucial you ask them about YOUR specific policy, whether it is covered or not can vary from one policy to another with the same company depending on how your employer negotiated their contract. .Also ask them if the surgeon you are considering is in network, if the hospital they use is in network, What percentage of the total bill you will be responsible for, what are the co-pays, and if there is any deductible you will need to meet...lastly ask them if their are any special requirements like a weight history, or a physician supervised diet that you will need to do first....Good luck!!!!

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