Anyone with Low bmi ---insurance paid???

xelapaul · 03-27-2006, 08:50 AM

Hey dear Texans

I am new to this forum but it seems great!!:) I live in NW Houston Area and I have narowed my MD search down to Spivak and Naaman any one have any sugestions on either one??? How helpfull is their offices in getting ins co. to pay??

I am on the 6mo dr diet before I can even apply for LAP-BAND^® surgery! I will be eligable to apply only in June

Until then the offices do not even want to talk to me. My bmi is 38 right now (and I have sleep apnea) I don't even know if my ins will cover it or not (have PHCS/Benefit Planers)
Has any one had a simular situation and had surgery covered? Please help I don't know if I should continue to jump thru the proverbial hoops or just go get a loan and pay for it myself:phanvan

maryb · 03-27-2006, 12:01 PM

My insurance UHC will only pay for BMI under 40 if you have at least 2 co-morbidities. Sleep Apnea should qualify as one. (Diabetes, High Blood Pressure, Arthritis, etc.) High Cholestrol doesn't count.

I had to pay for mine because I only had one.

Good Luck!

mermoore · 03-30-2006, 11:53 PM

I am also insured through United Health Care and was approved 100% with a BMI of <40 and 2 co-morbidities (High Blood Pressure; HTN). My physician is Dr. F. Spiegel and the approval process was really quick (one week from initial visit).

YellowRose · 04-03-2006, 06:33 PM

Hey, I have a couple of questions. First What is BMI? I am over 300#'s and have hypothyroidism and growth hormone deficiency, both of which are a major cause to my obesity. I also have sleep apnea and arthritis, will I be able to get approved for the surgery?

maryb · 04-04-2006, 07:21 PM

BMI is Body Mass Index. It is calculated by Height and Weight.
http://www.halls.md/body-mass-index/bmi.htmn BMI Calculator you can run your numbers.

I am 5"4" starting 207 lbs. My BMI was 35.5

sasweet1 · 04-17-2006, 06:32 AM

Hi! My name is Shirlie and I live in Conroe. I am new to Lapbandtalk and realize that you may have gotten lots more information since you posted this, but your BMI and insurance are identical to mine and I was approved in 10 days....no problem-o! I was banded on March 14 by Dr. Richard Collier at Houston Surgicenter. Good luck to you!