BMI of 30 or More With Diabetes

TRI STATE BARATRICS is pleased to announce that we were recently able to get approval for the Lap-Band procedure for a patient with a BMI of 32 with diabetes through an external appeal process.

There are over 20 million people in America with type 2 diabetes, many of whom are obese and have BMI over 30. The FDA has approved the Lap-Band for patients with BMI of 30 or more that suffer from serious medical conditions such as diabetes.Unfortunately, many insurance companies currently do not approve bariatric surgeries for those with BMI of less than 35, even if they have diabetes.

We strongly believe that early intervention with bariatric surgery can avoid or mitigate many of the serious life-threatening medical conditions associated with severe obesity, such as diabetes. Recently, we have had several patients with BMI less than 35 that were initially denied the procedure by their insurance companies. We then assisted the patients in appealing the denial through a process mandated by the NY State Insurance Commissioner to go outside the insurance companies, a process known as external appeal. We have been successful in having the external appeal overturn the initial denial, allowing patients with BMI between 30-35 to obtain the Lap-Band procedure.

If you are a patient suffering from diabetes and have a BMI of 30-35 and are willing to work with us to fight for your rights to have the Lap-Band surgery to lose weight and to keep it off, and are willing to follow our dietary guidelines, we will assist you to challenge your insurance company to cover your procedure.

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