Question:
i dont quite meet the 100 lbs or the bmi

my bmi is 37 aand i weigh 215 i need this surgery if dr gibbs denies me as far as qualifications i need a nearby surgeon that will do a lap rny that isnt so strict on the criteria is there one out there that will help me?    — blank first name B. (posted on September 21, 2001)

September 21, 2001
Mica, I emailed you a link to a Dr. Baker in Little Rock. His criteria may be the same, however.
   — Marilyn S.

September 21, 2001
Hi,I was 213 lbs when i had my open RNY 10 weeks ago. My insurance company covered it in full. I have united Health Care and my Doctor was Dr. Newhoff in Phoenix Arizona. Best of luck to you email me if you want to chat more.
   — Jennifer L.

September 21, 2001
Hi, my BMI is only 35.7 and my insurance will cover it. Aetna covers with a BMI as low as 35 with severe comorbids. I have severe sleep apnea. Do you have any severe comorbids associated with your weight?? Check with your insurance company for a full explanation of benefits.
   — skymaxjr

September 22, 2001
Hi Mica!--I had a situation similar to yours a few weeks ago-(I am now 24 days post-op)--When I went for my first consult--my BMI was 38.2--the dr told me to go home and gain some weight and come back in one month for a reweigh--He wanted me to gain the weight by increasing my muscle mass and that meant walking and lifting light weights-I also ate as much could but that got old real fast!--fast forward to one month later--on the morning of my reweigh--I drank 2 liters of water-I went in to reweigh and voila! BMI was at 40.5--The dr told me that when I started losing weight--I would look like a skeleton if I didn't have any muscle mass under my fat--I know he was right--he also said that BMI of 40 is usually approved right away by most insurance companies that have WLS benefits--he was right again--I was approved for surgery in 2 days!--my advice is to try and increase your weight--or find another surgeon that will help you--also find out exactly what your insurance benefits cover as far as WLS--best of luck to ya!!
   — karen D.

September 23, 2001
I have the same problem. My bmi is 38 and I applied to my insurance co. anyway with no comorbities to see what would happen, and not suprisingly they denied me coverage based on a low bmi. So, I am going to wait out about three months, when I am sure during that time I will gain weight anyway, then I will go back when I know my bmi qualifies. I have also tried to contact my insurance co. so that somehow in writing they will give me a letter of the exact reason that they denied my coverage. Dont Give Up!!! Things take forever. I started to consider self-pay and taking out loans and so on. But, if you self-pay, your insurance co. will not pay for any medical expenses accrued in the event of complications, so you could really find yourself in major debt. I know this is the best thing for me. I reasearched WLS about 8 months before I even went to a consultation. If you are sure this is for you, then you need ot figure out a way to make it happen. Good Luck!!
   — Tara J.