HMO Blue of New England

Hi everyone! So glad i found you all. Could please give me some information? I have my first appointment with surgeon Tuesday the 14 of this month. I called my insurance company and they said they do cover it and the prequalifications are over 40 Bmi, failed attempts at weightloss, obese for atleast five years and be an adult. I meet all of those and have high Triglicerides, Pcos, Gerd and shortness of breath and weight 242 and 5'4. How long do you think it will take till I get a surgery date? I know people say it is a long process. What makes it take so long? How long did it take for your process from start till surgery? Thank you all so much

I know you called your insurance company to get what their qualifications are but you will need to have them fax or mail you a copy of their criterias as well. This way there will be no misunderstandings as to their guidelines. Since each insurance company is different as well as the guidelines set by your surgeon, the timeline would be set with regards to insurance and your surgeon. You can get a better idea when you sit down and discuss all this with him. It'd be great to have your insurance info with you when you see him. Most surgeons will do all the paperwork for you which expedites the process for you but make sure you keep a record of everything you have done and are doing for yourself. Educating yourself on this whole process is the most important part of WLS. This is a life long commitment to YOU and for your health and I wish you the best of luck on your journey to a new life. Lorraine

Karolina - I have HMO blue and was approved in 1 day! I also had (now gone) Type 2 diabetes. No more meds and no more testing my sugar....incredible! My surgery was at Emerson Hospital. Their program is fairly new, but with experienced surgeons so I was able to get a surgery date a few weeks after approval. The whole thing soup to nuts only took 2 months from my first informational meeting. Your weight and height were very similar to mine and I'm already down to 216 at 2 weeks post op. Best of luck Leslie

Thank you so much for the info. I have my appointment at 10 am the 14th. I will keep you updated. So glad you are doing well after your surgery. If you would like to tell me about you surgery (procedure, pain, eating, ect.) I would love to hear about it. Thanks again

Hi there, I also have HMO Blue NE. They have all of my paperwork and I'm waiting to hear from them. They've only had it since Monday and I'm supposed to hear by mail. Hopefully by the end of next week I'll know something. I am having my surgery with Dr. Lautz at Brigham & Women's. There were three months between my first consultation and my scheduled surgery date (although I had to wait 2 months for the consult so 5 months total). I also looked into Baystate Medical Center and was told that the weight from the initital consult was about a year and that getting to the initial consult could take 6-9 months. I could be dead by then!

HI, I had Harvard Pilgrim as my insurance carrier. I called them and asked them if they cover it and they said yes as long as the surgeon thinks it's necessary. I work as a Medical Biller, Insurance rep, so HMO Blue, Tufts and Harvard Pilgrim only require that you go to a pre-op meeting. After going you set up your appt with the surgeon and then he/she discusses options with you. I saw my surgeon on 9-1-05, got approved on 9-2-05 and had surgery on 10-18-05. I went to Brigham & Women's, best hospital to have it done at. What you mentioned above about the insurance company having you meet all that criteria is only for those who don't have HP, HMOB or Tufts. All other insurances, most of them commercial ones require that you do a diet of some kind for 6 consecutive months, go to a group meeting once a month for 6 consecutive months as well, and a few other requirements. Hope this is of some help tp you. Lisa

HI I have HMO Blue and was approved with in days. They were great. My BMI was 41 and I had sleep apnea. Everything eles was fine. I have been attempting to loose weight for 20 years and just listed the diets I had been on with my doctor. Good luck- though I don't think that youll have a problem. donna

Well, I have to say that HMO Blue has treated me very well. Two years ago, my Lap RNY was approved. Now 2 years later, my plastic surgery is approved, just a Tummy Tuck, but hey, that insurance rocks! It took me about 9 months to get a date for surgery once I started the process, but depending on other issues that you may have (medical, psych, etc) it may take more time, every person is different. Good luck!