Horizon BCBS of NJ
I contacted a new surgeon today b/c I'm switching to a procedure that my current surgeon does not do. I spoke to the insurance coordinator at the new surgeon's office in NYC and she told me that Horizon BC/BS of NJ no longer requires the six month medically supervised diet. Can anyone verify this for me? If it is true, that would be amazing. I'm 3 months into my medically supervised diet, but the sooner I can get surgery the better.
Thanks for your input!
Leah
I had surgery in October, but had applied much earlier (like March of 2007)
I have BC/BS NJ PPO. There are different plans, so the PPO rules might be different. I was not required to do a 6 mos diet at that time.
Pam
Instead of complaining that the rosebush has thorns, be happy that the thorn bush has roses.
ross is 20 months out from surgery and he has BC/BS Horizon of NJ and he had to do a 3 month dr supervised diet back then -- it depends what is written into your specific policy -- it was a new rule when we went for surgery -- mine was a 6 month diet for aetna --
Ross & Roberta Cassety
Ross - Open RNY 5/22/06 - 373/194 - BCBS Horizon NJ
Roberta - Open RNY 11/22/06 - 228/126- Aetna QPOS
Let someone know that you are thinking of them
www.angelsforhope.org
Ross - Open RNY 5/22/06 - 373/194 - BCBS Horizon NJ
Roberta - Open RNY 11/22/06 - 228/126- Aetna QPOS
Let someone know that you are thinking of them
www.angelsforhope.org
Hi Everyone,
Thanks for your replies. I spoke with Horizon BCBS of NJ today and they said that all they require for pre-certification is a note from my PCP saying that the surgery is medically necessary and not cosmetic. HOWEVER, when I pressed for more info and written verification, he conceded that the dr. would need to PROVE I needed the surgery by submitting office notes for a six month medically supervised diet. I assume they will want all of the other things my original surgeon told me: proof of obesity for five years, support group attendance, psych eval and nutritionist meetings.
Oh, well. I'm halfway there.
Leah