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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 03-26-2008, 09:51 AM   #1 (permalink)
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Question Can you loose too much before surgery?

I'm just starting out in this process. I weigh 274 right now and my BMI is 42. The Dr's office said I probably won't have to do the 6 month diet- the insurance doesn't specify how long the diet has to be. But if I do end up having to be on the diet, what if I lose enough for my BMI to go below 40? Does that automatically disqualify me???
And for the 2 week (or however long it is) liquid diet before surgery, can you lose too much and disqualify yourself at the last minute? That would suck!
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Old 04-09-2008, 07:30 PM   #2 (permalink)
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I asked the nutritionist this at my apt. on Monday. I am right around where you are with the weight and BMI. She said it would be very rare to be able to lose enough to not qualify. I would actually have to lose 7 BMI points because I have co-morbidities. Do you have any comorbidities? That will likely make the required BMI much lower
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Old 04-09-2008, 07:49 PM   #3 (permalink)
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The course I went through required us to loose 10-15lb to show that we could follow a programme (albeit for a short time). But as I was going to have an umbilical hernia repair at the same time, the more I lost, the better my chances were of having the RNY and hernia repair laproscopically, I ultimately lost 35lb.

My initial BMI was 43.2 and on the day of surgery it was 37.4. I had no comorbidities.

The pre-surgery liquid diet is to shrink your liver. The doc won't disqualify you for losing too much during that period.
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Old 04-11-2008, 04:00 AM   #4 (permalink)
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It's won't hurt you because the majority of insurance plans look at your weight history. If it's properly documented that you had a BMI of over 40 and were to do a MD sponsered diet and get below that, they still look at the previous 5 years. The good news is the heavier weight will still count. When I review WLS for a patient, I take the highest weights provided for that year and my coworkers do the same here. I was afriad of the same thing and only lost 5 lbs during that time. Once I was approved, I had a month to go before surgery and lost another 18 lbs. I didn't know that it wouldn't matter. Sue
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