Question:
Has anyone been approved for Weight loss surgery with less than 100lbs over?
Please no bashers but I was interested if anyone had been approved for weight loss surgery with being less than 100/lbs over say 90% over? The Doctor said that it is medically necessary and he would send the paperwork to the insurance company, because of family history, and because of health reasons. — [Anonymous] (posted on February 13, 2002)
February 13, 2002
What is your BMI? If it's over 35 and you have co-morbidities or if it's
over 40 even without co-morbs, that will probably help. Most of it depends
on what your insurance policy states. Mine says 'either 100 pounds
overweight OR twice normal body weight'. The 'normal body weight' comes
from an insurance table of appropriate weights for corresponding height.
Good luck.
— garw
February 13, 2002
My girlfriend really pushed the rules, but she got approved. She was 23
years old with a family history of diabetes, but she had not yet developed
any co-morbidities herself. Also, she was only about 75 lbs. overweight.
What she did was put 10 lbs. weights in each jacket pocket when she saw the
surgeon the first time. (naughty, naughty) That put her BMI up close to 40
and, with the family history of diabetes, the insurance co. approved her.
Is this insurance fraud? Probably. Has the surgery still totally changed
her life, health, prospects? YES! I actually think, if I had been put in
her shoes, I might have done the same thing. She has since lost 100% of her
excess weight and is maintaining fabulous health. She also met/married the
man of her dreams and is very happy.
— Terissa R.
February 13, 2002
There was a girl at our last support group meeting that said that she had
lost seventy something pounds and had reached goal. She was on the shorter
end of the height scale, but her beginning BMI was a qualifier. That is
what counts.
— Cheri M.
February 13, 2002
Hi, I was 89lbs overweight when I started and was approved by Oxford
without any problems. I do have PCOS which is considered a comorbidity.
Good luck.
— Ella P.
February 13, 2002
I have a BMI of 39.7 and many people think that I am crazy for wanting this
surgery. Only you know how you feel and what weight is good for your body.
I did not have the severe commorbidities like diabetes, or high blood
pressure but the surgeon fells, with the high cholesterol and other issues
that I have, I am a good candidate. It really depends on your insurance
policy. I have United Healthcare and they approved me in two days.
— Lynn R.
February 13, 2002
I am 5'5" and I was 221 when I went in for surgery on Oct. 8, 2001. I
don't remember what my BMI was for sure, but it was around 37 I think. I
have juvenile rheumatoid arthritis and I just had my knee surgery done Jan.
8, 2002. So they used the need for that as a co-morb. I am 4 months out
and weigh 155. Very thrilled. I would like to lose a little more, but I
don't mind it's going slow now because I am such a worry wart. I always
stress I'll lose too much. But doing good. Good luck.
— alicialeew
February 13, 2002
I am 5'7" and my pre-op weight was 228. That put my BMI at 35. About
75 pounds overweight. (according to the charts) My personal goal is 135.
(Charts and surgeon say 147 should be goal) I have Aetna and was approved
with no problem at all. Sleep apnea was my only comorbid. email me with
any questions.
[email protected]
— skymaxjr
February 13, 2002
Hi, and good luck to you on your journey. I am 210, 5'4" and my bmi is
just over 35. I have a few co-mo's, and I was approved almost instantly by
BCBS PPO(California). Don't let other people talk you out of this just
because "they don't think your big enough". I get that all the
time. Yet, most WLS patients will tell you they wish they had done it
sooner. I wish you all the best! Email if you have any other questions.
— Michelle P.
February 13, 2002
I was 208 ( only 4'11") and needed to loose 80# but myBMI was 40 +
alot of co-morbids, I qualified in24 hours!!! Your BMI is your qualifyier.
— Cindee A.
February 16, 2002
i was well over 100 pounds myself, but my dr. said at the pre-op class
he got a person approved who had to lose only 40 pounds, but he had to
prove the health reason why it needed done..
— bruce M.
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