Question:
Is is possible to qualify with your insurance, but not with the Surgeon?

When starting this process, I was at a BMI of 39.4 with several co-morbidities. Trying to get healthy before the surgery etc. (My consult is 4/27/00) I have lost 15 lbs. mostly due to stress, but some I attribute to more exercise. The top Surgeon of my medical group weighed me at 275 on March 13, now I am 260, which lowers my BMI. My insurance, "Pacificare," says with a BMI of 35-40 I can still qualify with 3 co-morbidities, that which I still have. The Surgeon that my group wants to refer me to, their program it seems, only accepts patients with a BMI of 40 and above. Should I try to gain weight? HELP... I know that this 15lbs loss is temporary if I do not get the surgery. I seem to fluctuate between 275-280 to 260. When they weigh you, you probably are not fully clothed. There is no way, I can have 15 lbs of clothes on anyway. What do you guys suggest?    — Cheryl C. (posted on April 2, 2001)


April 2, 2001
Ok, so you haven't as yet seen the surgeon, right? If that's the case then I've heard that you can drink a bunch of water right before going into the office (a gallon of water weighs 8.34 pounds)- sounds disgusting to me but whatever. The BMI of 40 is usually applied to individuals WITHOUT co-morbidities; 35+ BMI for indivduals WITH co-morbidites as I understand it. I'd suggest calling your PCP or the surgeon and getting the info straight from the source.
   — Lynn E.

April 2, 2001
Watch out about that water overloading. A quart of water is one thing--plus heavy shoes, jewelry, and a big meal before the office visit ;-) But drinking a gallon of water--and some are that desperate I know--can make you VERY ill. If you don't vomit it all up right away, you can get seizures and so on until your body fixes the dilution by dumping the excess.
   — Jesse M.




Click Here to Return
×