Any 35 BMI'ers with No Comorbities get approved for VSG
Hello everyone. Well I'm 5'11 and weigh 257 pounds. My first appointment for VSG is next month and per my insurance company Cigna they will cover VSG if you have a BMI of 35 with comorbodities or a 40 BMI without any comorbodities. My BMI is currently 35 and I'm not aware of any issues. During my last exam I was borderline diabetic but for the most part healthy. My husband has been complaining about me snoring really loud as of lately so there maybe a chance that I have sleep apnea. I never thought there would be a time when I wished I was heavier. So my question is am I wasting my time trying to get approval through my insurance company? Should I just look into self pay in Mexico? Or do I maybe have a slim chance of getting approved through my insurance company? Will the coordinator at the MD office on the 20th be able to give me a better idea of my chances? In order to have a BMI of 40 I would need to weight at least 285 pounds I can't see myself gaining anymore weight. I've heard of people doing crazy things to weigh in at a certain weight and honestly I've entertain the thought but it would be my luck I get caught or something even worst so I'm stuck. I would rather stay home and get the surgery rather than have to travel to Mexico especially since my insurance will cover it. I tend to gain about 10-15 pounds a year. What should I do lightweights....I need help. It's funny because for the first time I'm not fat enough That's absolutely insane. Any advice would be apperciated, good, bad, and ugly...
Definitely have the potential comorbidities checked out and documented. You never know until you try. Good luck and keep us posted.
--gina
5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
******GOAL*******
Starting BMI between 35 and 40ish?
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DS on Aug 9, 2007 with Dr. Hazem Elariny
Get yourself tested for sleep apnea. That is a qualifing co morbidity. Is your pre diabetes documented. Not sure but that might help too. Your surgeons office should be able to submit all info to insurance, I would try it. Nothing to lose by trying to get approved.
RNY 9/12 TT 9/13 HT 5' 4" HW 250 SW 242 CW 125
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on 7/12/13 5:03 am
We Ill I was a self pay in Wyoming. 12,000. I am 5'1no health issues and started at 186 pounds. My only advice to you is do what ever it takes to have the procedure. its so worth It. and some people think I am wealthy , ha I only make about 18-20,a year. My point is dont let insurance or money stop you. Theres always a way. Good luck