health plans inc

has anyone had any dealings with health plans inc(new hampshire)?we called and they do cover wls,but they would not go over all of the details,they basically said you have to have a bmi of 40 or more,or 35 with two comorbidities.they are affiliated with harvard pilgrim.i hope this insurance issue goes smoothly when the time comes.~sigh~

Hi Jennifer, I'm dealing with Harvard Pilgrim right now, and with the plan we have, my PCP had to refer me to the WL program (Dartmouth Hitch**** in Manchester) and they will have to submit a request to the insurance company for an approval. In my case there shouldn't be an issue, since I have the bmi and comorbidity requirements. Don't give up, it's a long road, but should be worth it! Good Luck

As of 4-1-06, I switch to Health Plans, Inc and Harvard Pilgrim. The insurance person at Newton-Wellesley was so confident about meeting their requirements that I was just scheduled for surgery on 5-1-06. I got this date even before I technically have the insurance coverage! N-W said they deal with Harvard Pilgrim all the time and didn't see a problem with the approval process. My BMI is over 40 and I have several co-morbidities. I had to call HPI several times and talk to different departments, but I managed to get someone to fax me the criteria (that was a no-no since I wasn't even a member yet!) If you have a fax # i'd be happy to fax you what I got. Your criteria may be slightly different, but it's a place to start. That criteria is info you need and are entitled to. I would keep calling bac****il you get it. One person who had the info but couldn't give it to me before I was a member was Care Management Services at 866-325-1550. They are the people who do the actual authorizing. Try them.