sort of in-between

nrpnrp · 04-26-2008, 10:23 AM

Hi all,

I am in my 4th month of the 6 month supervised monitoring. I am at 35.2 BMI. After years (I am 63) of fighting up and down, I know I need to do something that is more likely to work. My doctors office wants everyone to lose up to 20 lbs in this 6 month period. If I lose that, my BMI will fall below the required 35. I know I may not be in the same situation as many but it is still a big problem. I have not been able to maintain weight lose for any period of time on my own. I need this surgery. Has anyone been in my situation and been able to qualify with BCBS? Any tips will be greatly appreciated.

maryrose · 04-26-2008, 10:38 AM

Welcome over 50 banster! I am 53.

Oh gosh. That's a tough one. I think you need to be in close contact with the clinic's insurance coordinator to make sure things are going the way they should in order to get approved. The clinic wants you to get approved, so they should be on top of this, but you want want to slip between the cracks.

I know they also want you to lose weight also to shrink your liver.

Do you have pre-existing medical conditions? They may also that into consideration also???

Good luck!

nrpnrp · 04-26-2008, 11:26 AM

Hi...
Thanks for the note. I see that you are doing very well with your weight lose. Congratulations! Do you have any regrets at all?

Yes, I do have other considerations like HBP, high cholestrol, sleep disorders and some heart burn/acid reflux.

The counselor in my doctor's office is very supportive and actually told me not to lose any weight during this period. I have been up and down a little but in total have gained a half pound. She said it is really difficult to predict if BCBS will approve me.

I do have a history of weighing about 20 pounds more than I do right now. Is that good or bad as far as getting approved goes? It seems that the benefits of LAP-BAND^® have been well established and that insurers would really help their clients. In addition, it may actually save the insurers money by relieving other payouts related to obesity.