Question:
I need to know if I would qualify before I pursue any further

My BMI is 36.5. I have always been overweight/obese. I was 185lbs at 12yrs. I am now 225. I have hypothyroidism, infertility, irregular periods, BP's higher than 10 years ago , have had hip pain in the past and now chronic back after a back injury. Familial history of diabetes, heart disease and cancer. Does it sound like I would qualify even with a low BMI???    — karentheloserIam (posted on September 18, 2000)


September 18, 2000
Hi Karen. From what I understand, if your BMI is 35+, and you have atleast 2 co-morbidities, you qualify for surgery. Best of luck to you!
   — Jeannet

September 18, 2000
I imagine that you want to know if you qualify for your insurance company. They all seem to have different rules. I have Kaiser point of service that allows you to go in-network to Kaiser and out-of-network with an 80%20% plan. Even though they are both really Kaiser each component has different rules. In-network, they turned me down, but out-of network I'm just awaiting final approval. Of course it will cost me much more. Most plans have written guidelines that you can request. That is probably you best place to start. Good luck. One last tidbit. When I first looked into the surgery my BMI was 37.8. In thinking about the surgery and all I might never be able to eat (and eating it now unfortunately) my BMI is now 40. I didn't puposely gain weight to get here though I've read comments from those who have.
   — Marilyn M.

September 18, 2000
It sounds to me like you have several co-morbidities. Just be persistent and know the facts. Don't let the insurance companies take away your chance to be healthy. Good luck!
   — Paula G.

September 18, 2000
My surgeon told me I would not qualify unless I was at least 100lbs overweight. When I had my first consultation my BMI was 38. Needless to say when I went back to her my BMI was 40. She told me not to go home and overeat, but that is exactly what I done. I could not believe they would deny me and I was so close. I was obese, but to let a little technicality hinder me. NO! NO!. I had the surgery about 9 months ago and have lost 90lbs. doing great. I can say the smaller you are the slower the weight comes off. Say a person weighs 400lbs they will lose weight quicker than a person weighing only 260. Whatever you decide to do, good luck.
   — Barbara P.




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