BMI, Lap-Band, & Empire BCBS

Well I changed my insurance because my company required that I be employed for 5 years before they would cover the lap-band surgery. I am now on my husband's plan and his covers the surgery the only thing is that to be approved for the lap-band, BMI has to be below 50. I currently have Empire Blue Cross Blue Shield. Has anyone had this same issue? Is there any way around it. I won't settle for a RNY, it is too much re-routing with that one. I'd prefer something a little easier on my anatomy.  My current BMI is about 56 and I am working on losing the weight it is just really hard and I know that the lap-band is the tool that I need due to its restriction. That will help me to keep my hunger under control. HumbleSista Monique

In 2003 I was approved for a lap-band from Empire Blue. My BMI was about 49 and no once ever said anything to me about there being a BMI limit at that time. Perhaps it is new or perhaps it is an exclusion that your company has integrated into their insurance. Campanies can adjust coverage so while I may have the same insurnace company, our employer may have a different level of coverage with that same insurance company. I do have to say that I was totally against the RNY but due to a less than great experience with the Band, I am now looking at a revision to an RNY. If I had known then what I know now... I probably would have gone with the RNY to begin with even with all of the rerouting!

What does your surgeon say about the lapband?  I know a lot of doctors do not recommend the lapband for people with high BMI like you have.  In fact, my surgeon flat out said in his seminar that he woldn't do a lapband on someone who would be more successful with RNY and vice versa.   Might want to check into that avenue before you get too far into the insurance issue. Pam

I'm going to stick my neck out here too, as a bandster who's waiting for revision, to consider RNY.  Lap banding generally isn't great if your BMI is quite that high - better for lightweights.  Typically long term loss with banding is less than 50% of excess weight, so it might still leave you morbidly obese.  Have you talked to your doctor about RNY?  It's not as scary as it seems. Kit

Empire has dropped the BMI below 50 rule.  I have empire and had to file an appeal to get approved.  After my appeal went through I found out they dropped that rule.  My BMI is 61.  And to the previous poster about only losing 50% of your weight with LapBand - you might want to do some more research, your numbers are WAAAY off.

Oh my gosh, that is wonderful to hear. I appreciate all of the advice but I must say that beyond the shadow of a doubt I know that Lap-band is the only way for me to go. I know that I can make it work.  Peace

The information was partially correct.  You lose half with the Lap Band that you would lose in the first year with RNY.  It starts to even out at the end of the 2nd year.  Lap Band results in a slower weight loss.