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Any NjHorizon revisions out there

I was banded in 2004.At that time it was band or bypass.I chose the Band.I am and have been miserable for years.I have completed me to terms with the fact that the band never really worked for me.I was initially 269 and got down to 219.never saw those incredible results.I have struggled with port site bain,bloating,port pain,aches and sliming and vomiting up.I have a "Barf" bag that I have on hand.I am always hungry,acid reflux is off the hook!I am a bulimic because I never know when I can keep it down.Had my gallbladder out 5 years ago.I am going to the doctor to see about a gastric sleeve revision.I am miserable and in pain. I have horizon NJ Health.I need them to cover this revision

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Hi. I am with horizon in nj and am having the sleeve done this month. I had the band out last month because my surgeon really doesn't like to do it at the same time if there is any stretching. I had to do 3 visits with a nutritionist and a psych. evaluation. Plus get a letter from my primary. Pretty much the same I had to do for the band. It really wasn't too bad. You basically have to show the band failed you not vice versa. Good luck!

  • Author

Thanks for your reply.I see my new dr that is in network on Monday.I have a referral from my PCP .I am just a mess.Was the nutritionist and psych in network?

No but I have out of network coverage so only had to pay a portion. My surgeon is also out of network but takes whatever your insurance pays for the surgery and doesn't charge you the rest (at least that's my understanding). The nutritionist is through him, but I pay the difference for her and for office visits.

  • Author

Problem is I currently have an HMO in network coverage only:-/

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Just saw the new dr.Requires a 3 month wait after removal.Going for an barium swallow test and X-ray to see if band has slipped.

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