Question:
CAN YOU GET THIS SURGERY WITHOUT A BMI OF 40 THROUGH SELF PAY?

I have a BMI of just below 40 and I will be self pay. I know insurance requires bmi of at least 40 but if you are self pay is that the Dr's requirement also or just insurance?    — DBXX (posted on March 8, 2005)

March 8, 2005
There have been people who were able to have it done with a BMI of 35 - 40 if their comorbidities were bad enough.
   — SnowWhiteDove459

March 8, 2005
I've seen where insurance will cover from 37 BMI. Your profile says BMI 32.1 - I would stay away from any doctor who would agree to do gastric bypass on 32.1.
   — Yolanda J.

March 8, 2005
The National In. of Health set the guidlines... 40 without comobilities, 35 - 40 with co-mobilities. if your insurance denied you because your bmi is just under, I hope you appealed first before self paying. Most surgeons are members of the baratirc association, and follow the NIH guidlines. If you are between 35 - 40 then, depending on your circumstances a surgeon may take you as a self pay. If your under that I wouldnt think they would - or should. The guidelines are there for a reason...
   — star .

March 8, 2005
If you aren't going through insurance approval, you'll still have to meet the surgeons' criteria. Since WLS is an elective procedure (meaning it's not an emergency/trauma situation), surgeons aren't required to perform it on demand. If you call a surgeon in your area, the office will give you what their requirements are to be accepted into their bariatric program. Most reputable surgeons will follow the standards of the ASBS and NIH guidelines.
   — Shayna T.

March 8, 2005
This is what I can tell you. I started with a BMI of 60, I am at goal and my BMI is 32. If you do not have co-morbidities that will be helped if not cured by drastic weight loss--you do not and will not qualify. Reputable surgeons follow strict guiedlines . I hope you find the answers you need and I wish you health. Bek
   — bek4901

March 8, 2005
My BMI was 33.3 and insurance approved it.
   — Mini Gadget

March 8, 2005
My husband had the DS to cure his type 2 diabetes with a BMI of 26. Yes, it's possible. If you have the money, you are in control. NOT the insurance company! DS for type 2 diabetes has been done in Europe for 10 years now and you don't have to be obese.
   — PattyL