Anyone here denied for Lap Band due to their BMI of 50+?

I have a BMI of 61, and am scheduled for a consult on 2/8. I really would prefer the Lap Band to the RNY. I think it's best for me, as does my PCP. I have BC/BS Personal Choice-- in Pennsylvania. I hear that some people are denied for being over BMI 50--- any experiences? -Shari

Shari, The decision is yours. This is just my opinion, based on the research that I have done. When you have a high BMI the lap band is not as effective as the Gastric Bypasses. I also know that most insurance companies only pay for a speciific kind of Gastric Bypass. I had my surgery at Pennsylvania. I had 280 lbs to lose with a BMI of 69. At the time(June 2006) PA hospot only did the RYN. 7 months later I am half way to my goal. I have lost 140 llbs. I genuinely believe that if I had the lab banding this loss would have not happened. Again, it is a personal choice but research it a little bit more. We have a longer journey than our fellow members, make it as easy on yourself as possible. Good luck with whatever your decision you make. Jeanne

I think it's dependent on the surgeon rather then the insurance company. You should call your provider and find out if they cover WLS and in specific what procedures they cover. If insurance companies cover WLS, they will normally cover the RNY, the DS, and sometimes the Lap band. Many companies (althought that is changing since medicares ruling last Feb) do not cover it, because it's results are less then ideal for some MO people. There was someone that posted here several weeks ago whose surgeon told him he had to lose over 100 lbs before surgery to get the lap band. I think you should go to your surgeons apt. and find out his medical opinion. If you have a good reason to have the lap band, over the DS or the RNY thats what you should get. I wanted the DS, went to a sugeon who only performed the RNY, he tried to talk me into the RNY, and convinced me on it. I went for a 2nd opinion with a surgeon who did the DS and RNY, he told me that the DS was a great surgery for SMO people (people with BMI's over 50), I had the surgery in Feb. of 2006 and I'm down 247 lbs. The DS was a good choice for me, but that was my choice, i'm positive I would not have been happy with the RNY, or the lap band. You might not be happy with the RNY or DS, so get the surgery you think is best for you. Scott

I planned for the Rny however after approval, my dr. advised it would be safer for me to have the band, and like your company..mine being BC/BS also... (one would think that if your approved for RNY the band would be covered also... ).. i had to get my BMI under 50 ... and per my doctor.. that was the same as losing 100lbs... needless to say i changed doctors.. and had the RNY done.. as I orginally planned... for.. I can only say good luck..