Question:
Anyone like me?
I'm going to a seminar this weekend for the lap band. My fear is that i will not have enough health issues to qualify. Although I'm blessed to not have major health issues, it is only a matter of time. My weight just keeps gong up and up and up. I've gained 14-16 pounds in 1 month. I don't know what the heck is going on. I've had my thyroid checked and was told oh it's fine. I've always struggled with my weight up and down, it wasn't until my daughter who is 3 that I just could not stay below 200. So my true question I guess is? Will a doctor or a insurance co. mine is Anthem Bluecross PPO HRA approve me based on my BMI of 37-38. I have noticed that I started to snore just recently and my knees hurt when I walk up stairs or do exercise. Is this weight related or age? I'm 34. Any advise anyone? — Titoes (posted on November 10, 2009)
November 10, 2009
I am also 34 have 6 children 5'2 my kees started to hurt my highest weight
was 238 I had surgery on 09/01/09 I am down to 182 lbs I started to slow
up but like you I just had knee issues snoring and asthma. Those together
and be difficult to deal with, but talk to your doc. Email me for anymore
personal stuff.. Good luck
— Sylvia M.
November 10, 2009
Snoring can be a sign of sleep apnea. As I learned recently, this can lead
to heart problems, so take the necessary steps to correct this. Tell a
doctor and do what he or she says. It also may be the "health
issue" that qualifies you for surgery.
— malkee
November 10, 2009
If you get a diagnosis for sleep apneia then that will help you to qualify.
Many insurance companies require a BMI of 40 or greater with no
comorbidities and 35 or greater with two or more. You bariatric surgeon
and/or his insurance person should be able to help you find the best way to
get approved.
— rkurquhart
November 10, 2009
I am 31 and had gastric bypass 10 months ago (when I was 30) on January 8,
2009. I went from 286 down to 171. At home I weight 168 but the dr.
office scale said 171. Anyway, I didn't have major health issues. My dr.
diagnosed me with GERD after my egd prior to surgery, and I was also
diagnosed with sleep apnea. This helped me to qualify. I haven't taken
any medicine for anything and sleep much better since surgery. My personal
goal weight is 135, so I have a little over 30 lbs to go. Hopefully it
will come off. Good luck on your weight loss journey. They should approve
you.
— Lyndsay30
November 10, 2009
You can also use family history of heart disease and high blood pressure as
well as diabetes.all which ran in my family.My dr put those in my referral
letter.i also suffer from knee pain and lower back pain and dr also put
that on letter.i know they want you BMI at least 35 or higher.sleep apenia
also is a big thing which another poster mentioned leads to heart
problems.snoring is a sign of that. i wish you all the best.
— carolyn1970
November 11, 2009
Thank you all for your input I didn't realize that snoring was a sign of
more than just being tired.
Thank you all
— Titoes
November 11, 2009
Unfortenately, I can't help much. I am exactly 100 lbs overweight with no
health issues. My insurance wouldn't pay for it, and after much discussion
with my significant other, I opted to take a loan from my 401k to pay for
the lap band. I feel lucky to have the option to do that, as I know others
can not. I know the decision is a costly one, but I just hated the thought
of waiting until the health issues caught up with me in a few years. You
may want to look at all financing options if you don't qualify. I know the
money seemed secondary compared to getting my life back. I somehow think i
will save the majority of my montly payment by cutting down on groceries,
eating out and drinks. Best of Luck!
— Heather C.
November 11, 2009
I'm generally healthy other than my weight - rarely get colds and I'm
pretty active. I'm a professional dieter - been doing it for years and
years lose-gain-lose-gain. I got my band 3 years ago. You'll learn a lot at
the seminar but it's not until you sit with your surgeon that you'll know
wether or not this surgery is for you. If he/she has completed enough
surgeries they'll have a pretty good idea if you'll be approved or not but
of course it's up to the insurance company to make the decision. I was
approved quickly and on the fist try (I was 35/no kids BMI 42 and have HMO
Blue Massachusetts) I wish you well on your journey! ~Christine
— C J
November 11, 2009
I'm a bit older than you (20 years :-) but in the same boat. Pretty healthy
overall, just too much weight. I am also looking for successful arguments
to make to my BCBS insurer in hopes that I can persuade them that I'm close
enough to their guidelines (BMI/weight) to cover. I'm trying to put dollar
figures on all of my continued health care should they not cover the
surgery. I have also had cancer so am trying to find evidence and arguments
related to the increased risk and re-occurrence as a high risk factor like
heart disease and diabetes.
— dullrich
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