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:

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.

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.

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