Looking at the Sleeve

Hi,

I am looking into the Sleeve and would like some info on what exactly does your BMI have to be...what do you have to weight. I am currently around 212 and I am 5ft 7in. Also what is the cost associated and does any insurance cover the cost?

Thanks in Advance for any replies

I can only tell you a few things about what my surgeon said to me. I can't answer your specific questions.

Here are some facts about me: I'm 5'4" and at my highest (insurance approved) I was 237 pounds.

I lost about 20 pounds with NUT advice while waiting to see surgeon (added some protein drinks into daily routine).

SURGEON VISIT:

I weighed about 220 (BMI about 38) and he discussed mostly sleeve and RNY but recommended RNY only for me.

REASONS:

1. I have reflux issues and with the sleeve reflux can get worse and that increases chances for ulcers.
2. I had serious neuropathy issues with my feet and chronic low back issue. Any weight loss would likely help the feet but with the low back, one needs the maximum weight off to make a significant improvement with pain.
3. RNY patients typically have greater weight loss than sleeve in the long run thus helping my back.
4. My insurance (Uniform Medical managed by Regence) only covers RNY and lapband (he did not recommend lapband for me at all).

From what I hear on the internet, cash payment for the sleeve is about $14,000. My RNY out-of-pocket was about $1,200 (already had paid my deductable for the year). Some people go to Mexico to get it cheaper.

Good luck! 

It seems every insurance Co has it's own rules.  2 yrs ago when I had surgery, mine didn't approve the sleeve, period.  I don't know whether they do now or not.  Your surgeon should know all the rules since they are the ones to get approvals.  Your insurance Co can tell you if any WLS is covered.  Mine RNY was but my cost still, with deductables and co-pays were about $4000.  The general rule for any WLS is 40 BMI or 35 with co-morbidities. 

Good luck.  We can give you estimates but you have to look at your own Dr and insurance for the details.

using your stats I figured you BMI to be 33.2. Unless you have comorbidities,diabetes,PCOS,high cholesterol,hbp,sleep apnea and others I can't remember,your BMI might not be high enough to qualify for ins to pay. A call to your ins co will get you the answer quickest.

Many who don't qualify with their ins have self paid and there is way less qualifications to have to meet. GL and keep us posted on what you find out.

While some insurance companies have different rules for different surgery types, most of them just have one policy no matter what type you get. You have to have a BMI of 35 with a co-morbidity or two or a BMI of 40 with no requirements for co-morbidities. 

If you self-pay, prices for a sleeve vary from around 12,000 to 20,000. I paid 17000 for mine.

My BMI, did not qualify me for insurance to pay...so I did self pay. I am 2 weeks post op and think it was money well spent.

My BMI was 31. 

:)

My BMI was 33, I was cash pay, 13,050.00.

thats because my insurance doesn't cover any WLS. I love it and would pay for it again even though I'm in a battle with food addiction at the moment , I will beat it with the help of  my sleeve.  I'm 5'1 surgery weight was 181. Before that was 186-189