Question:
I NEED TO KNOW IF I QUALIFY FOR....?
HI EVERYBODY AND CONGRATS TO ALL OF YOU FOR THE WEIGHT LOSS. I HAVE A QUESTION, IT IS POSSIBLE THT I QUALIFY FOR RYN EVEN MY BMI IS 39.1 AND HIGH BLOOD PRESSURE? THANKS FOR YOUR HELP. — agnes0627 (posted on October 15, 2007)
October 15, 2007
Are you self pay? If so, yes! Your doctor will have to be the one that
makes that decision, but mine says yes. Also, if you are trying to get
insurance to pay for it, that depends on where they set the BMI. My
insurance says 40 or above and must be medically necessary. I am at 39, so
my doctor says we can work with it! My height is what makes me a 39 as I
am 5'11. I am waiting on the insurance now to see if they will pay. I
should know within the month.
— katann
October 15, 2007
Depends on a lot of factors, but comorbidities such as HBP, high
cholesterol, diabetes, sleep apnea, etc. generally help the surgical
process. My insurance says BMI of 40 or above without comordidities, or 35
or above with them.
Good luck, and keep in touch!
— obeseforever
October 15, 2007
Agnes, I just remembered - if you go to the Lap-Band forum on OH, to the
left under Lap-Band System Forum is a heading "Do you qualify?"
That may heal you decide if you can swing this with possible insurance
coverage and MD OK.
— obeseforever
October 15, 2007
Hi...just had my RNY last Monday and I have a BMI of 36, no co-morbidities,
my insurance said NO WAY so I was self pay. I chalked it up as preventative
maintenance :) Good Luck
— Mimi3
October 15, 2007
It depends on your weight and a few other factors. I mean, you usually have
to be 100lbs./+ over weight and a BMI of 39+. You need to find a doctor and
see what he can do for you. I am sure everything will be ok. GOod luck
— D. goza
October 15, 2007
Let me revise that. My insurance standards are 35+. I was approved all out.
I would not recommend the lapband. You have read the horror stories. My
surgery is the 24. Just do your best. Good luck
— D. goza
October 16, 2007
Yes, I am pretty sure you will qualify, but the insurance is another
matter. Just a thought----Have you looked into the possibilty of a
Vertical Gastrectomy Sleeve? It is another option. Check out the VGS
forum. I will have the VGS on Oct. 25. I'll keep you posted. Pat
— pjennjr
October 16, 2007
I qualified with a BMI of 39.1 and I am 5'6. My insurance covered my
procedure. Check into having a sleep study done to see if you are apnic. If
you are this would help you to qualify. I am now 1 year out so I know it
can be done. Just do not give up on this. Best of Luck to you.
— The One
October 16, 2007
My BMI was only 38 and I qualified, I think it just depends on your
insurance company and what if any other complications you have due to your
weight. I had all of my issues documented by my doctors prior to my
application to insurance. Good luck!
— [Deactivated Member]
October 16, 2007
BCBS Fed covered all but $100. BMI was 39 with 2 comorbidities (Diabetes
and High blood pressure) and I was 223 lbs. Now 140. It all depends on the
insurance and how good your doctor's office is at requesting. Make sure
you go to a Bariatric Center of Excellence. They know how to do it all.
Go for it.
— debramc
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