Question:
BMI is 39.1 am I a candidate?

I've been considering having surgery. But Im not sure if I qualify,I've researched and found that i may be a can qualify.I dont suffer from high blood preasure or diebitis, I do suffer from depression because my weightof and I have a poor self inmage of myself. I am 5'7 @250lbs can anyone advise...please    — Jan D. (posted on April 14, 2007)


April 14, 2007
I dont know ,my bmi was this low but I had feet problems.I was healthy other wise.It took me two years to fight Insurance company to pay.You can have it probably if you are self pay.
   — Sandy Hanson

April 14, 2007
Most insurance companies require a BMI of 35 or higher so you hit that mark. They also require a comorbitity as you mention. I do not know if depression qualifies. If you are not medicated for it at this time I would suggest having your Dr. prescribe something and then apply to your insurance company for the surgery. Depression was one of my issues but I had several others as well. When was the last time you had a general blood work up to check things like thyroid, cholesterol, etc. Maybe your cholesterol is up and you don't know it yet. Sorry to be negative but we have to look for reasons for the insurance company to aprove surgery. Get a good check up and see if anything turns up. Good Luck and God Bless, Norma
   — njkbutton

April 14, 2007
When I had weight loss surgery, i was 5'6" and weighed 246 pounds. I qualified. Once you go through all of the pre operative tests, they might discover a comorbidity that you didn't even know exsisted. For example, I had a sleep study and found that I had a mild case of sleep apnea. So, that was my co morbidity. Prior to that, being fat was my only issue...didn't have any other health problems.
   — Lisa M.

April 15, 2007
I know that I was 100 lbs. over the weight limit, and I had 6 out of the 7 pre-existing conditions for having the surgery so it was approved by my insurance and medicare. My pre-exisiting conditions were depression, sleep apnea, high cholorestral,diabetes, copd, heart stint. I am 5 months out of RNY and as of now I no longer have sleep apnea, am down to 1 pill for dibetes, am trying to get off of my depression pill, and do not take any cholorestral medicine anymore. Hooray! Good Luck to you and hope your insurance approves you!
   — Virginia M.

April 15, 2007
Go to the doctor first!!! There is no cheap way to find out...the dr's office will know what criteria your ins. co . requirese and if you fit in it!
   — LouAB

April 15, 2007
The quick answer - probably. The long answer - my doctor, my medial group and my insurance company all had their own set of criteria - lots of hoops to jump through - but in the end; insurance covered and I got through it all. I am 5'8 and was 277 @ time of surgery. 286 was my highest. I am 225 today. starting week 9 since surgery. Good luck. OH..my bmi at surgery was 40.
   — jammerz

April 15, 2007
Most people stand tall stretching when getting height checked. Plus over the years most shrink a little, I have been told its from our sines cmpressing espically MOs since we carry so much weight. Re Run the BMI calculator at 5 feet 6 inches, one one inch less height your over 40 BMI. This may be important for insurance approval:)
   — bob-haller

April 15, 2007
A framily history of co morbids, parents siblings close blood realtives can also help. Not just diabetes and high BP, things like cancer can also be tied to weight. GO GET EM! WLS the BEST DECISION I EVER MADE IN MY LIFE!
   — bob-haller

April 15, 2007
My BMI is 39.9-- I am 5'3" and 225- I had no problem getting approved with Independent Health. My surgery is Thurs. Good Luck.
   — Jackie W.

April 15, 2007
My BMI is 39.9-- I am 5'3" and 225- I had no problem getting approved with Independent Health. My surgery is Thurs. Good Luck.
   — Jackie W.

April 15, 2007
Jannette, it truly is an insurance question, what your individual insurance requires. The bottom line is that many women with a bmi of 39 have had approved surgeries, even with low health issues. They will look at bp and other issues, but also on joint deterioration from the compound weight. Call your insurance company and see your PCM or surgeon to get a consultation, this is the only way to know for sure if what you have will work for you. Take care, Patricia P.
   — Patricia P

April 16, 2007
If it were me - I'd seriously consider pursuing a surgery like the Lap Sleeve Gastrectomy (also seen as VSG) - there is a very active forum here on OH, and another on Yahoo. Do your homework! Make sure you know what it is you're asking for. Blessings, dina
   — Dina McBride




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