Any NJ PBA member or spouse dealing with insurance coverage issues?

My husband is a police officer in NJ with a State insurance plan. I've been denied by Cigna and now I would like to change insurance carriers to one that will cover the gastric bypass. Is their anyone out their that has had the least amount of issues getting approved that can recommend a carrier for me? HELP! I"M DESPERATE!!

I wish you luck. I had cigna pos and they covered me. A lot depends on the coverage that your employer buys. A close friend has BC/BS and was covered, maybe check that out.

Dear Karen, I have Horizon NJ Plus thru the state health benefits plan. I wrote a letter detailing my history, got one from my primary doc, submitted the reports from the psychologist, nutritionist and surgeon and was approved in 4 weeks. No fuss, no problems. I wish you all the best!

Dear Jim, Thanks for taking time out of your life to answer my question. My husband is a police officer in NJ, and I never realized that their are exclusions in my Cigna plan whi*****ludes Gastric Bypass Surgery. I can switch insurance companies in Dec., so I'll have to wait for surgery. I'm sure it'll be worth it. Thanks again!

Greetings Karen, Any success with the insurance issue? Never thought I would be on this type of web site. After 4 children and history of keeping 20 pounds per child, the numbers sure add up. Not quite sure of how I feel about the idea of WLS. Am I taking the easy way out? Still many issues to work out. Have not even gone for consult yet, still researching surgeons and want to make sure I find the most comprehensive approach. Best of luck, Nancy

Try contacting whoever the other insurance company is (the one you can switch to) and find out if they cover it and what their criteria are.

Hi Karen, I had laproscopic RNY gastric bypass surgery on March 15th and have had absolutely no complications. I have Oxford Health Plans and I was told by my surgeon that this is one of the best insurance carriers to have for WLS. I had no problem at all getting approved and they paid 100% of the cost. I have no co-morbidities and my BMI was about 43 at the time of the precert process. I would definitely recommend Oxford if you have the choice. Feel free to email me if you have any questions or just want to talk, especially since we are neighbors!! Best of luck to you in your journey. Debi

I have the state of NJ health benefits (blue cross/blue shield) and was approved within 2 or 3 days for my bypass (October 2002)They also paid for the extensive preop testing and my hernia repair post op.

Hi Karen, My husband is a member of the FMBA in Nj and my lap band was covered almost %100,(i have paid $39. so far) !! We have Horizon Traditional B/S & B/C through the city. My friend had by-pass (her husband is also a firefighter) and so far she has been covered completely also. Good luck on your journey !!

I have BCBS POS and I got approval in a few hours. My doc is very experienced with dealing with the insurance companies plus his office staff know their way around the jargon that is needed. From what I hear some of the Blues are going to be dropping the bypass surgeries in 2005 so make sure NJ still will cover it. The hospital was covered 100% ($33,000.00) for a 3 day stay including charges for OR. I thought I should get a discount since I didnt eat anything! LOL kelly -58