Hello all, I am new here. My PCP broached the subject of bariatric surgery recently. I am pretty interested. Has anyone dealt with this insurance company recently and bariatric surgery? When I called they told me the first step is to do 12 months of a documented weight loss program before anything else related to surgery. Timing wise, I found this a bit discouraging- as I have time intensive goals next september. Anyone have experience going through Horizon NJ Health? Thanks.

UPDATE: I'm so relieved after calling Dr,Goldstein's office (with Virtua/Kennedy) in Voorhees, NJ. I called him because he accepts Horizon NJ Health. I spoke with the coordinator and she assured me that there is no 12 month wait, that the operator at the insurance company is reading from a manual that is not current, and then incorrectly interpreting what the writing means as they relate it to me.

She told me that first I need to attend a seminar (October 9) before I can have a consult. Said I will additionally need a recommendation from my primary, nutritionist consult, psych consult, five year weight history from my PCP, any record of gym membership in the last year (which I have). I asked if I can start this now with the primary, before the seminar, in order to not waste time. She said yes. I have an appointment with my PCP, who recommended the surgery in the first place, on Monday!

I'm so excited. I look forward to and am motivated to getting into my best shape before surgery.

On a related note:Groupon just posted a great deal on Curves that can get me 20 visits for $39. I think, considering my level of (un)fitness that this may be a beneficial gym to join.

Hi.... Your dr is my Dr too!! I just wanted to introduce myself and let you know .... Maybe we can be support to each other....

Hi.... Your dr is my Dr too!! I just wanted to introduce myself and let you know .... Maybe we can be support to each other....

Hello You are using Dr.Goldstein also? I see Dr.Attia listed as your surgeon. Either way I'd love to talk. I'm contemplating changing surgeons, Attia is on my list. Did you have your surgery yet?

I have Dr. Attia. He is wonderful. Sleeve date 12/16.

I had Dr Attia when I started a year ago... But then I started working again and couldn't make all my appointments so I stopped... When I started up again in August I went with Dr Goldstein because I had to switch from HorizonNj Health to United Health Care because CHOP didn't take Horizon and my daughter had to have surgery.... And SJHC doesn't take United.... So I switched.... I like Dr Goldstein and Dr Attia...I feel more comfortable with D Goldstein than I did with Dr Attia....

I have Dr. Attia. He is wonderful. Sleeve date 12/16.

Hello! How long was the process with Attia if I may ask?

Do you mind if I ask why you feel more confortable with Goldstein? Do you have a surgery date? I have my consult on Oct 28, after attending the seminar. Only thing is- Goldstein seems to push lapband. I am curious how many sleeve's he has performed compared to other doctors. I listened to a radio interview from Nov 2011 that he did, where it sounded like he only performed Banding at that time.

He sounds like a competent, skilled surgeon. Just not sure how supportive he is of VSG and how practiced he is.

I'd love to hear more about your experience.

I started in April i was finished my insurance requirements by July. I was denied initially because I was not on meds for my comorbidities. (Low bmi). I appealed and won in early September. I scheduled my surgery in December, they had dates that were sooner.

I started in April i was finished my insurance requirements by July. I was denied initially because I was not on meds for my comorbidities. (Low bmi). I appealed and won in early September. I scheduled my surgery in December, they had dates that were sooner.

Thanks for sharing, and good luck to you!

Thanks and your welcome.

ThickNThin.... Who is doing your psych consult.... I am having a hard time finding someone... If you don't mind my asking??

ThickNThin.... Who is doing your psych consult.... I am having a hard time finding someone... If you don't mind my asking??

A Better Tomorrow in Millville- 856-776-7211

She charges a flat $150 for the evaluation. I believe you fill out a long questionnaire, she talked with you a while, and it takes about a week for the clearance to be mailed to your surgeon.

Hi. I had my initial appointment with Dr. Goldstein on 5-30-13. From his seminars, it is clear he favors Lab Band, but he does Sleeves also. I completed my check list around the end of August, my insurance (Horizon NJ Health, plan D) approved my surgery on the first request. My Sleeved is scheduled for 11-19-13. My insurance covered everything except for the nutritionist and Physc clearance. I'm both excited and nervous. After my last appointment with Dr. Goldstein he really made me fill at ease and I trust him as my surgeon.

Hi. I had my initial appointment with Dr. Goldstein on 5-30-13. From his seminars, it is clear he favors Lab Band, but he does Sleeves also. I completed my check list around the end of August, my insurance (Horizon NJ Health, plan D) approved my surgery on the first request. My Sleeved is scheduled for 11-19-13. My insurance covered everything except for the nutritionist and Physc clearance. I'm both excited and nervous. After my last appointment with Dr. Goldstein he really made me fill at ease and I trust him as my surgeon.

Hello! Thanks for the feedback. Horizon NJ Health doesn't cover the nutrition consult? That's crazy, since it's required! Do you mind if I ask you a few questions. I think it would be very helpful since you are using the same doc, with the same insurance plan as I am.

What preop requirements did the doc and/or insurance have?

Could you have completed the checklist faster and gotten a surgery date faster?

I'm hoping to have surgery after this semester ends, and before the next- so around Dec 19 if possible.

Was the doc supportive of your preference for VSG over banding?

Thanks

For my pre op checklist I had to have clearance from a gastroenologist, blood work, a letter of medical necessity from my primary, a five year weight history, clearance from a cardiologist (I've had previous heart issues), a barium swallow, and the nutritionist and psych clearance. As I previous stated, the last two were not covered. The nutritionist cost me about $150 and I went to Dr. Kagel in West Deptford for my psych clearance ($220). I started in the beginning of the summer so between my work schedule and doctors taking vacation.....that made things a little longer, it took me about 3 months to complete the check list. There were no issues with insurance approving the surgery date. Dr. Goldstein respected my decision for VSG over banding, all in all I'm happy. It's your body, your choice.