Qualification questions...any experience?

BG0103
on 12/14/19 4:15 pm

After starting the process almost 3 years ago and then bailing due to husband's sudden health issue I find myself here again.

I'm back to considering the VSG. My insurance covers it (Aetna) but I'm reading stories of people being denied because their weight history has an occurrence on a BMI under 35 in the past 24 months That would be August 2018 for me

After putting off surgery my Dr. put me on Vyvanse. It worked for a while and at one weigh in my BMI reported at 34.8. Problem is, I self-reported my height all of these years and I'm actually an inch shorter than I thought I was so I guess that's water under the bridge. If I had let the Dr. measure me I never would have been under 35 BMI.

Has anyone been denied because of this? I mean, the weight came right back at the next 3 month checkup. I stopped the meds and am now at my highest weight.

Thanks!

White Dove
on 12/15/19 8:35 am

This depends on your insurance company. I had to submit a record of every diet I had ever been on, along with the beginning and ending weights. That was my surgeon's requirement. If your insurance company has a requirement that you were never below 35 BMI in that time frame, then you might have to wait, or an appeal might be successful.

The only way to find out is start the process and see what happens.

Real life begins where your comfort zone ends

BG0103
on 12/15/19 9:38 am

I do remember having to list all of that when I started the process before. I could pretty much much off every box for every diet!

I have multiple weights with the doctor for that year so I'm going to see how many they request, I was in there every three months so maybe I can just give them one for that here. If not it just means that things would be bumped until August which isn't the end of the world.

I just went through all of my records, tests and procedures from when I started this process a few years ago. I had one month left of my 90 day nutritional and exercise program. I had done almost all of my blood work, met with the psychologist, pulmonologist and done all of my G.I. x-rays and procedures. I could kick myself for having to do all of this all over again.

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