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Insurance (NJ) horizon BCBS !

Brittany Paige

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Brittany Paige    1

Brittany Paige
Posted

Has anyone gotten the sleeve through this insurance RECENTLY? Over the phone, I was told a 12 month nutritional program but I've searched a million forums on here, and no one was required to do that ! Also, I haven't been insured for 7+ years, so no other doctors have my weight history /: TYIA !

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Hoven    33

Hoven
Posted

They should be able send you the exact policy information. I found the information on my insurance website and I have Empire BCBS, so i'm guessing you should be able to find it too. I just but in Bariatric in the search engine. I wouldn't rely on a phone call. If you know where you want to do the surgery, they have insurance folks who can help clarify too.

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kcdavidson42    10

kcdavidson42
Posted

I have BCBS of Illinois and I wasn't required to have nutritional program. I just had to show medical necessity. I had to have a psych eval, an ekg, a stress test, and my primary care had to sign off on it. The process was fairly simple. I had my first appointment on 12/23/14 and I am being sleeved today 2/23/15. Good luck with the process.

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CountryGirl5584    115

CountryGirl5584
Posted

I have BCBS NJ Advantage EPO. I just got sleeved on 2/9. I didn't have to do a 12 month nutritional program. I had my first consult on 12/11/14. It may vary by plan. What BCBS NJ plan do you have.

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linzlou2000    193

linzlou2000
Posted

Hi! I'm a lurker and made an account just to let you know you are not alone!!! I'm on my husband BCBS health insurance (he is a state employee) and I have to do the 12 month nutritional coaching program also! I started September 30, 2014. I have to do 1 call a month and I have to graduate the day after my first call. It ends up being 13 calls. Fingers crossed I'll get sleeved in October. Just know you are not alone ????

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lastingdreams    57

lastingdreams
Posted

I'm BCBS New Jersey and was sleeved in August. I didn't have a 12 month requirement. However, I have the NJ Direct version which I think it a lot more flexible

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locjewel    14

locjewel
Posted

I'm BCBS New Jersey and was sleeved in August. I didn't have a 12 month requirement. However, I have the NJ Direct version which I think it a lot more flexible

Hi, I have the exact same insurance. What exactly did you have to submit to nj direct? I'm just starting out and want to have everything lined up for a speedy approval

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Read2016    658

Read2016
Posted

@@Hoven I have empire BCBS too, any insight on how the process has been? I'm meeting with the team next Wednesday, surgeon, nut and psy.

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Hoven    33

Hoven
Posted

Hi, My experience went off with out a hitch. I did not have to do a 6 month medically supervised weight loss, but was told that the requirements had just changed. But I had started the process so I didn't have to do that. I had it done at NYP.

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Read2016    658

Read2016
Posted

Do you have any clue when the requirements changed? I have something dated 1/5/16... I'm guessing your in NY, maybe your a teacher too lol... I'm planning to use Lenox hill

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Hoven    33

Hoven
Posted

Hi. I am in NY. The requirments changed last year about the time I had my surgery in April 2015. I had Dr. Bagloo as my surgeon and have had no problems except for acid reflux. My primary care doc has been super too. I am so glad I did this and have no regrets. Life is good.

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
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