The Empire Plan - NYSHIP

Im just wondering what the policy is on weight loss surgery?
Ive heard some say there is a 6mo. supervisted diet before you get approved, while others say there isn't.

I have the empire plan(nyship) through my father who is a state employed worker.

Does anyone know the guidelines? or have been there with this kind of insurance.

Any help would be great! Thanks

I am a state worker too but I don't have The Empire Plan. Have you talked to your dad - he can call them & ask for the info or maybe he can give you the 800 # to call. I am pretty sure they cover it (NYS is one of the few employers who include this rider). You could also check out their website & see what you can find. Also, talk to whatever surgeon you plan on going to - they will probably know what your provider requires... they knew exactly what mine did even though I checked it out ahead of time.

Most plans require some form of supervised pre-op diet plan... mine was 3 months. Don't let it deter you from getting the surgery - it's for your own good & for your health. Many times the surgeons require it too to make sure you are serious about losing weight & can handle the changes & sometimes it's for health reasons - I needed to lose enough so I'd survive on the table. If you are really serious about having the surgery you will do whatever it requires - I know I did!! (3 months of a liquid Medifast diet was my test!!)

Good luck & if you can't get any info let me know - I know enough people that have the Empire Plan I am sure someone will make a call for me!!
Cece

Here is something that was found by another Poster, I hope it helps. I do not know specifically how they interprete the pre-opt dieting.

http://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htm

Hi there,
I am a NYS employee & I have Empire Plan (NYSHIP.)  United Health Care did not require a supervised diet before approving me, however, their approval is only good for 6 mos (they approved me this past Sept.) so, if I don't get a surgery date before that time, I'll need another approval.

Good luck!

I have the same plan and didn't require 6 month of supervised diet.  I was approved in 24 hours after I met all of my surgeons requirements.  I would have your dad call the human resources department and have them look to see if they have that additional rider on the plan.

Hugs,

Patty

I am a NYS employee and have the Empire Plan.  United Healthcare did not require the six month supervised diet.  Once I had all the pre-surgury evaluations required by my surgeon, his office submitted the information and I received my approval in 2-3 days.
Good Luck!

I'm a state worker and I have the same insurance. When I called them I was told that I was required to have the 6 month supervised diet and my surgeon also confirmed the 6 months of supervision. I know that others have not have had to do this. Maybe it has to do with what part of the state we are in? I'm in Brooklyn. I'm not sure so I suggest you or your dad call the insurance company and speak to your prospective surgeon. Good luck!

I too am confused about United healthcare- empire plan. I was told by the surgeon's officed that they require a 6 month supervised diet; however, when I called UH, they said approval  is determined case by case.I find this unsettling because if I had insurance through some unknown carrier, I might get approved tomorrow. Why do city and state employees have to jump through hoops for everything???????????