Qualification questions - my first post!

[gracemarie723 0]

Hello all!

My name is Gracie, a little about myself- I am a 21 year old college student from Long Island, NY. I am 5'8" and currently 220lbs, and have not been under 200lbs since I was 14. I have tried every diet, weight loss program, pill under the sun, as have many people on here. My final goal weight would be 150 as the healthy weight range for my height is 140-160. I would think that 70lbs would qualify for the surgery. I have tried doing research online for gastric surgery for years, and have recently decided that if I were to get one, that the sleeve would be the best decision for me.

My insurance is GHI (EmblemHealth) and my BMI is 33.8. I have seen the charts many times that state that the minimum BMI required for most insurances to cover is 35 (with 1 or two serious health issues). The only thing that I take medicine for is PCOS, although I do get joint pains when I try to do basic exercise or walking for a extended period of time. Is there any chance that insurance would cover, any help from someone that has had a similar experience. As I said I am still in school so my budget is not a large one, but I live in NY and that shows to be one of the more expensive states for this surgery and I would not even know where to begin but I am thinking more and more about this and want to have it taken care of so I can begin to live my life to the fullest.

That is my rant! Any information would help more than you know. I will attache a picture so you can get an idea of my body type!

Please keep in mind that they do no justice for my size.

Edited June 7, 2016 by gracemarie723

[rosestara 48]

I haven't had a similar experience but I have been reading these boards for months and insurance companies are very strict. Even people who meet all the requirements and have 100 or 200 pounds to lose sometimes get denied by their insurance. So, I don't think you would be able to convince your insurance company to qualify you since you don't even meet their minimal requirements. They tend to be very strict about that and look for reasons to deny people. I meet all the qualifications with a bmi of 50 and I still might get denied. Also although weight loss surgery does help PCOS, I don't think most insurance companies count that as a co-morbid condition that they cover. I might be wrong about that but it isn't listed under my insurance

Edited June 7, 2016 by rosestara

[Read2016 658]

I'm in NY and sorry but this is going to be discouraging... I've consulted with 3 well know bariatric surgeon's, first question when I called for an appointment was what's your height/weight... Lennox hill has free seminars run by the surgeon, you maybe be able to attend one just gather information... The entire insurance thing is annoying.

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

Edited June 7, 2016 by nyteacher125