Insurance help!!

[cutie8892 0]

Hey everyone!! I am 19 years old, weight 319lbs, & my height is 5’81/2 (my BMI is 45 I think). I’m really nervous over my insurance not covering the surgery due to the fact that I don’t have any comorbitities. I’m generally pretty healthy aside from the fact that my feet hurt from carrying so much weight. My health insurance is healthfirst through Medicaid & I am on the last month of my “6 months weigh ins”!!! Do you think I might have a problem not getting covered?

[Nonnaof4 54]

Hey everyone!! I am 19 years old, weight 319lbs, & my height is 5’81/2 (my BMI is 45 I think). I’m really nervous over my insurance not covering the surgery due to the fact that I don’t have any comorbitities. I’m generally pretty healthy aside from the fact that my feet hurt from carrying so much weight. My health insurance is healthfirst through Medicaid & I am on the last month of my “6 months weigh ins”!!! Do you think I might have a problem not getting covered?

I think you will be fine as insurance requires you to have a BMI of 40 or above with no comorbitites. At least in NYS.


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[ypease 177]

Insurance companies are a breed unto themselves. And anything associated with Medicaid can be problematic. I don’t think anyone here can really answer for sure whether an insurance company will authorize or not. A lot will depend on your doctor. What have you and your doctor talked about? It sounds like he has put you on some type of path towards authorization. Is that correct?

As you have probably noticed, some people on this site have had some tough times getting things approved, while others have had no problems whatsoever. When it comes to insurance companies, they can be a pain. Good luck.

[New&Improved 1,780]

Most places say 40+ no comorbidities needed

[GradyCat 3,693]

You're probably okay with your BMI

[mdhender87 9]

Hey! I’m 302 and 5’4 and 32 years old. I also don’t have any comorbidities except for foot and ankle pain I have, usually more severe after working. I think as long as we are meeting the requirements that insurance has set for us beforehand we will be fine. I just finished my 6 month of weight loss appointments that were required and am waiting to hear whether or not insurance has approved me for surgery.

[AngieBear 2,524]

Mine was 50+ with no comorbidities. I had to gain 8 lbs. it was ridiculous. Insurance varies. You should call yours to get specifics.

[Midnightsun 129]

I would call and have them email or mail you the requirements. They will do it for you. bcbs was 35 with Comorbilities or 40+BMI no cormobilities.