Question about BMI

This is my first post!  I recently started researching the Lap-Band.  I am going to an information seminar tonight.  I already contacted my insurance and was told that 'if eligible' it is covered at 90%.  I asked what made me eligible and the lady said BMI.  My bmi is 38.8, but I am still unsure if I qualify as I am 209 lbs.  It jut doesn’t seem like I have enough weight to lose to make me eligible.  Does anyone have any opinions?  I have called the office to ask, but haven’t had a return call yet. 

 

 

To be approved for WLS your BMI has to be over 40 and you have to have some medical issues like high blood pressure, sleep apnea, diabetis. I Believe 100 pounds over or close to it. Hope this help... Montego

Welcome to the VA Board! Hopefully you will find the support you need here! As for your question....My understanding is that for most insurances the BMI requirement is 40. BUT, if you have other co-morbidities you could get by with a BMI of 35.  I'm sure at your meeting tonight the surgeon or staff will go over what they typically run into with insurances.  SO...my question is....if YOU don't think you have enough weight to qualify, are you sure you really want to go through all of this?  I know I would have my surgery again tomorrow, but I also started at over 220 pounds overweight....I still don't even weigh what you weigh now!  There is a gal that posted on the Main OH board that has a blog you may want to check into.  She shares her story and views on those having WLS that don't have other co-morbidities....interesting stuff. Her site is: www.meltingmama.typepad.com. This recent post, among others, explains her stance http://meltingmama.typepad.com/wls/2007/05/i_like_to_sit_o.h tml  Keep in mind her language is colorful and her approach is direct, so it's not for everyone (though I find it refreshing and funny). Of course, she (like I) had RNY, not lap-band, so this may change the view a bit. Hope this helps....research away...there's lots of information out there!

Make sure that you specifically ask the insurance company if you have the rider on your policy.  If you ask them in general terms as it seems you may have, they will almost always say yes but you must find out if you have the rider.

Good luck!

Christine

 

When I called I asked if they specifically cover WLS.  She said yes, and said that they would also cover any clinical needed to see if I was eligible.  To be sure I just called (4^th time in 2 days) and the Very nice person said that the information she giving was from the morbid obesity rider coverage.  I also asked about any pre-authorization needed for the psyche. Exam. 

 

 

Thank you!