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Anybody got AARP Medicare Complete aka Secure Horizons



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I was told they will pay all but $150.00 but they say it's all up to my PCP to prove I need it. They can't tell me what they require as proof. Does anyone know? I have an appt. with my PCP next week. I hope he sees it my way.:mad:

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I just found out today that Medicare requires a 6 month supervised diet, I am not sure if yours follows the CMS/Medicare guidlines or not but it kinda of stinks if you ask me. Most times you can pull their policies up on-line and look for Morbid Obesity.

Good luck in your search.

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SecureHorizons is the Medicare product from PacifiCare. If you qualified for the surgery itself, PacifiCare used to require a 6 month telephone counseling, plus a psych eval and nutritionist. They recently dropped the telephone counseling requirement. Because PacifiCare and SecureHorizons are offered by the same company, they probably have the same requirements, but no guarantees. My doctor's office knew exactly what my insurance requirements were when I went in for the seminar. I would think your best bet would be to check with them.

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Has anyone used GHI PPO plan, if so do you know what their preapproval requirements are and which procedures are covered?

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      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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