Horizon NJ PLus bc/bs

Anyone have it and how long did you wait for approval. I am only 3 days out and already nervous and counting the days. I heard that denials are being handed out more frequently too : 

no, not at all....  it's just that NJ Plus used to be the insurance plan that was given to civil service workers in NJ.....  i didn't know if it was available to anyone else....   Mary  C

aarrgghhh,  Note the day I joined OH  and then the surgery date....  It took me 2 years to get approval.....   depends on what kind of WLS surgery you want.  I wanted a DS, and had to go to court several times....  finally, they changed their policy, and 1 month later I had surgery!   Are you a state employee?    Mary

i work at a school. I hope I have better luck than it seems you had. 2 years of waiting???? I couldn't take that. I want to get the lap band.

From other folks at work who have had the lap band,  that's the easiest approval....  you should get a rapid reply!  They had no trouble once the doc submitted everything.   Mary

Mary, I'm wondering why you ask if she's a state employee? Is it easier to get approved if you're a state employee?

Thanks,

Nereida

Be very careful with Horizon BC/BS. I posted a couple of months ago that they are giving approvals for WLS or Plastic surgery , then a day or two before or even after the surgery they are saying they never approved it. A co-worker was due to have lap band procedure done on 5/30. On the 29th they called to say they needed more info. I know of several cases where plastic surgery was done with approval - with code numbers for the approval - but they declined to pay the surgeon saying they should not have given the approval. The plastic surgeon was told to go after the patient for the payment. I can only suggest that you document all your conversations with them, all approval numbers and save all the paperwork. Be sure to write down the names of everyone you speak with. Hopefully you won't have any problems but I've already seen it happen too many times. The best of luck. Wilma

I have BCBS HMO, it took about 48 hours for my approval once my paperwork was submitted.  Dr. JB & his staff are awesome!!  I had the LapBand on Monday and am feeling really good right now.  I received a call from Dr. JB's office first then I received a letter from BCBS saying that I was approved, so hopefully they wont try to get out of it, I could never afford to pay for this surgery.  Good luck to you. Jackie

Hi. I'm new to these message boards. I have Horizon HMO, NJ and when I called to make an appointment yesterday I was told that everyone with an HMO is considered self-pay. It's frustrating to not even be able to make it to the appointment stage. Who is Dr. JB? Maybe I can still find someone to help me. My PCP and I both agree that surgery is the answer for me. Thanks so much!

When you speak with the insurance companies now they can give you a confirmation number. That is really a log of your conversation that is on file. Before I get that I ask them to go over, in detail, what we discussed that day. This might help.