Newbie

I'm just starting on this journey - had my first consult ~3 weeks ago.  My BMI is 39 (this is the heaviest that I've ever been).  It seems that my insurance would prefer it if my BMI had been higher for the past 5 years and may not approve surgery.  Has anyone had this experience?  Were you able to get approval eventually?  I must add - this site is GREAT!

my bmi was 38.9 but i had high blood pressure,  elevated triglycerides,  arthritis, and borderline diabetes.  If you have a co-morbidity that can make all the difference.  Do you have health issues?  Each insurance carrier has their own list of qualifying illnesses.  Best of luck to you jeani

Welcome aboard!  Sounds like you have BCBS insurance or some other one that likes to put people through as many hoops as possible. Get a copy of the requirements so you can see for yourself what they're looking for. Good luck!

--gina

Welcome!  It all depends on the comorbidities, bmi and your insurance company.

Hope it all works out well for you - keeping our fingers crossed for ya!

But - many on here were disapproved the first, and some even the second time around - and finally won their approval!  Hang in there and don't accept their decision if they say NO.

WELCOME to our LW Board!!!!!   We LOVE Newbies so don't be afraid to ask questions, talk about concerns, or just ask for encouragement!!

Just from what I've read if you don't have any health issues most insurances want your BMI to be 40 or above.  If you have health issues then it can be in the high 30's. 

What would it take to raise your BMI up to 40...Gain a few pounds or slouch a little when you get measured.  Check with you insurance company and see what requirements they have and then you will know what's expected of you. 

Welcome!  My BMI was dead on 40.1 and I am exactly 5 feet tall.  I didn't really have any co-morbidities but ONE month during my 6 month-supervised diet I had borderline high-blood pressure so my family doctor put down in my records that I had hypertension....not really a lie but it helped get me approved. 

I got my 5 year weight history from my OB/GYN and I had hovered between 37-40 BMI except one year that I lost about 40 pounds on Weigh****chers....that year my BMI was around 33.  I gave a written explanation and I was approved for surgery in about 3 days with no problem.

Some people also end up getting a sleep apnea test and have a mild sleeping disorder they weren't aware of...that will count as a co-morbidity too!  Get your doctors on your side...they can often word things in your favor or "tip the scale" in your favor (my doc told me to weigh with my shoes since I was borderline!)

Good luck and glad you are here!!

Welcome Jen,

If your BMI is truly an issue gaining a few lbs to slip you over 40 will  make the insurance company happy. BUT it would be easier to check your policy. 

Almost every policy out there follows the Medicare guidelines of over 40 unless you have co-morbiditors then it's over 35 BMI. The main co-morbids are diabetes mellitus, obstructive sleep apnea, degenerative joint disease, circulatory and respiratory insufficiency, arteriosclerosis, hypertension, dyslipidemia, or GERD.

I hope that helps. I had no trouble getting approved the first place I went (at a 35.4 BMI) but I switched surgeons because I switched procedures and my original surgeon didn't do the DS on lightweights. We just now got all the paperwork together to get it ready to go.

Anyway, welcome. Liz

Welcome aboard! You're right this is the best most supportive group!

Hi Jen and welcome to the LW Boards.

Please talk to your insurance company and get a written copy of their requirements like Gina suggested.  Then you know up front what you must do and how to do it.  Don't rely on what someone is telling you.  So many people do what someone tells them to be disappointed when they file that they should have been doing other things also to be approved. 

Do you have any co-morbidities?  That is usually taken into consideration if your BMI is below 40.

Good luck and keep us posted.

Linda

My BMI was 39. My ins. company did not require medical documentation of my weight for the previous 5 yrs, but a "personal" history...so I fudged a little on the dates and weights.  I also bent my knees a little during official weight/ht check that made me shorter and my BMI 40 or 41.  I did have GERD, but I wanted a little safty net. 

Like was suggested, find out exactly what will be required by ins. co for approval and what surgeon will require...they are not always the same.

Good luck, and welcome to the LW board.