Just wondering if anyone has the Horzion Blue EPO NJ insurance. I just got a new job and this is the insurance they offer. I want to get the lap Band done, but my last company did not cover under insurance. Please let me know thank you...

Horizon BCBS of NJ has an excellent approach to banding, so as far as the carrier is concerned you should be OK. The question to answer is whether your company has a custom contract (most large companies do, where they can choose various options about what not to cover--bariatric treatment is often excluded) or if it's one of Horizon's standard plans.

If the latter, I can tell you that Horizon does cover banding for qualified patients.

Horizon BC/BS of NJ does cover banding but be sure to get the list of requirements in writing as they change them from time to time. When I first saw Dr Bertha the only requirements were a referal from your PCP, a psych eval (which the do not cover), a consultation with a dietition,weight records for the last two years. Now (6 days before my scheduled surgery) they require a six month supervised weight loss program. and when they changed the requirements they said no exceptions.

I have Horizon blue cross and they covered the band and the fills as well.

Did you have your surgery yet?

I am also going to Dr. Bertha

I finally got my approvall after the six month supervised weight loss program my date is now 7/29/08

I also have the same BCBS EPO NJ as you. All paper work and tests were submitted july 14th and today I got a Packet in the mail of insurance forms for the doctors to sign, claim forms. I took this as a positive sign.

Any Thoughts??

Usually those forms go directly to your sugeon and they take care of them. I never saw any of those forms, but if you sent in the paperwork hen maybe thats why they sent the forms to you. I'm only guessing. Good luck.

BSWHIP08, I'm sorry I took so long to answer. I'm having my surgery tomorrow, 7/29/08. I can't wait. Dr Bertha is my surgen. Any thoughts???

I have BC/BS HMO and I had my surgery on the the OCT 29. Today I got a bill for around $5000 is that normal? I thoght they covered it all.?