Got my surgery date scheduled...waiting for insurance

Hi Everyone,

Been lurking on these boards for awhile now.  Just wanted to share that I've passed my six-month waiting period.  I've been working with my doctor on maintaining my weight and getting my diabetes and high blood pressure under control.  Thankfully, the diabetes is being well controlled with medication.  My high blood pressure is still a concern, it's still considered pre-hypertension levels, but it is most likely higher right now due to my dad's sudden death last month.

I'm scheduled for gastric bypass on 1/5/2009.  My PCP and surgeon (Dr. Bertha in Florham Park) are working through the paperwork issues right now.  I'm hoping I can get approved.  We have the Horizon BCBS Direct Access plan.

If you could send good thoughts my way, I'd appreciate it.  I feel like I'm waiting for the rest of my life to start!

Good Luck!  1/5 will be here before you know it.  That office is usually pretty good about getting the paperwork through quickly when all the insurance prerequisites have been completed!

Hope you are on you way soon!

Vicki

Hi Queen B,

All i have to say is that you have chosen the BEST DOCTORS, EVER!!!

They will take good care of you. They are excelent working with insurance, they will let you know the best way to get you approved. Overall, they are my doctors and hands down the best in the state of NJ (my opinion).

We will be waiting for you at the Losers bench.

So sorry about your dad passing away.

God bless you,

Much Love,

Miriam

I got terrible news today.  After telling me for months that I would be approved for surgery as long as I was under medical supervision for six months, my health insurance company (Horizon Direct Access PPO) now tells me all bariatric surgery is excluded, regardless of diagnosis.  They said there is absolutely no way the surgery can be approved and an appeal won't matter because it is in an exclusion in our health policy.  I was told at least 4 or 5 times that it would be covered.

I am devastated.  I feel like my life is over.  I want so much to be able to have children and with my diabetes, high blood pressure and weight-related infertility, it looks like this is going to be impossible.  We don't have the money to pay for this surgery on our own.  I am just so disgusted and can't believe my health insurance company lied to me for all those months.

Hi

I am new to the forum and I have only been to my doctor twice.  He assured me that my insurance will apporve my surgery.  Now you have me worried.  I have NJ direct15. 
Did you do any follow up?