GHI questions

So I have sat here for the past 2 days (can we say obsessed?) Reading every post in this section, I have myself going crazy worring about a denial well before my papers have been submitted (was denied 3-4 years ago but never fought it) I have GHI-CBP my husband is a NYC busdriver (he had surgery at the time I was denied) anyway I haven't seen much posted on this insurance either good or bad.  I have a BMI (at the time of my first consult) of 38.7, severe GERD for about 5 years still on meds daily which are no longer helping at all), I was recently diagnosed with PCOS/insullin resistance and prescribed metforim, I am on anxiety meds. So basically my question is since I am a "lightweight" have the backing from all my Drs, and weighins consecutively since November of 2006...........what is the chance of getting an approval? and if denied appealing? I am getting myself sick over this and yet I have my last test for my EGD )which i already know i have acid reflux disease but its not a recent enough test....I also have a hiatal hernia they found from the last test. thank you to anyone *****ads this gina

Hey Gina: I'm not sure what type of surgery you are instrested in or if it makes a difference ....  I bought a self pay plan with GHI in June - applied for Lap Band in July and was approved in less than a week. My BMI is higher than your's so I'm not sure what GHI's specific guidelines are for lower BMI's. Most seem to state if the BMI is under 35 (some go up to 40) they want to see 2 co-morbities as well. Sounds like you have that covered and you've done the 6 month diet.

 

Hopefully you won't have a problem. If you do, you can always appeal and if that fails, go to the state level. NY seems to be one of the better states to push things through. Good luck!

 

Dear Gina, submit your paperwork and relax. I have ghi bc/bs ny from the nypd and was just approved. If you don't get approved then hire Gary Viscio. I just got approved and will have a ds 10/02/07. God Bless cindyb

Hi Cindy Thanks to the response to my post, I happen to hit a brick wall right now . cant submit yet due to a bunch of ulcers and not getting clearance from my gastro Dr.I have to repeat the test Nov. 1. So we shall see what happens after then. gina