Healthnet NY & Other Insurance Carriers

When I went for my consult the billing person kept saying how she hated my insurance company and they are a "pain in the butt".  I have Healthnet Advantage Platinum.  She said I will need to see the nutritionist for 6 mths before even being considered.  I am able to change my company this month (effective Jan 1) through work which will give me other options.  Can anyone let me know their approval process for the Lap Band with Healthnet if your profile is similar to mine---BMI>40 no comorbidities?  Or if with that profile you had quick response with another carrier.  I have some options like Oxford, BC/BS, etc.  TIA!

I have healthnet and it took me a yr to get approved with them.  I had RNY though.  I fought with them for a yr.  I had a BMI<40 and comorbities.  It sucked but they finally got tired of hearing from me I guess.  I put in 2 appeals.  Then they finally approved me.

Hi there.  I have Oxford Freedom and had no problem at all being approved--no six month diet, etc.  it was a matter of 1 week from the time my surgeon's office submitted all the test results required by them  (all standard--cardio workup, psych eval., etc. that all docs require****il I was approved.  And my BMI was below 40 with high blood pressure & possible sleep apnea. On of the doctors in my practice is in network w/Oxford Freedom, and one isn't.  I chose the one who isn't because he's senior and I was a revision from band to RNY.  My out of pocket with his office is $1000 max/year.  Now that I know his partner, I would have been equally comfortable with him. From what  I hear, Oxford Freedom is good w/lapband approval too.  You should ask the billling person what her experience has been with them.   Good luck.

I have Healthnet Platinum too and they paid 100% of my surgery including doctors, hospitals, etc.... I was told that from NYU, Mt Sinai & 4 other NYC hospitals I'd have to do the 6 month diet, have different doctors send letters of referral or recommendations--Now I laugh in their face since Dr. Roslin had me approved within a week of submitting. No 6 month diet, no b*tt load of referrals and recommendations. A HUGE portion depends on what doctor you choose I'm so greatful for Dr Roslin and Lenox Hill!!