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In NEED OF!!! Medicaid, Horizon NJ Health

mandoozita862412
on 9/14/09 12:54 pm - Middlesex , NJ
I had a surgeon close to my home that I went through the 6 month process to get the lapband surery with. Then I lost my insurance and got pregnant all the month before my surgery was supposed to take place. Hoping my father, who I was insured under, would get his job back in the 9 months I was pregnant, I planned to go back and get the surgery after my son was born. He did not and now I unfortunately only have my medicaid insurance with the hmo of horizon nj health. I cant seem to find any doctors that will take any form of medicaid insurance, CAN SOMEONE PLEASE HELP!!! even if i have to travel, as long as its not tooooo far, i will. All i need is to find a surgeon and my records can be transfered and I can get the surgery as soon as Im approved. If anyone knows of a doctor please let me know.
Tom C.
on 9/15/09 5:12 am - Mount Arlington, NJ
REALIZE Band on 01/29/08 with
Maybe this link can help

http://www.obesityhelp.com/forums/NJ/3462382/MEDICAID-AND-MEDICARE-SURGEONS-LIST/


How about contacting Medicaid and ask them.

Final suggestion, go to the PA and NY boards (or any other state that is close to you) and ask.
Good Luck on your Journey !!

Tom

“Nothing I will ever eat will give me the feeling I get as when I lose weight”  The views expressed are based on my own experiences - and should NOT BE FOLLOWED IN LIEU OF DOCTOR’S ADVICE/INSTRUCTIONS. Only your Doctor knows your condition, and make sure you talk to them before making any changes to your diet
chell1957
on 9/19/09 7:44 am - Woodbury, NJ
I do not know your area but here in Camden County is Dr.Marc Neff. He is located in Cherry Hill and uses JFK health system. I know this a drive for you, about an hour I am sure but he is very good, has a great personality and bedside manner. Very caring.  856-665-2017. I have the same insurance as you and i was approved for the sleeve. Good luck.
 
http://verticalsleevetalk.com/private.php
http://www.obesityhelp.com/forums/wls_lightweights/


 
                            
Karen B.
on 9/20/09 7:32 am - Lawrenceville, NJ
 All of the HMO's that Medicaid and NJFamilyCare offer have doctors associated with them that can perform RNY or Lap Band surgery.

Call Horizon and they should be able to provide you with names that you can contact.

Just be aware that they may mandate requirements that your previous insurance did not require - once they provide you with names, the doctor(s) should be able to let you know what hoops you will have to jump through to fulfill their requirements.
 So far, so good.

 
jrsygurl520
on 9/22/09 7:12 pm - middletown, NJ
Dr. Onepchenko in Egg Harbor by atlantic city takes it I know because I have nj health and i am doing my 6 month dieting now.

just a heads up for those of you saying to call insurance and find out who we cant because they do not have the right information the only way to find out is to call doctors and ask and they can tell you right then and there if they accept it
Karen B.
on 9/22/09 8:08 pm - Lawrenceville, NJ
 In the case of Medicaid, Medicare and NJ FamilyCare providers they DO tell you the names of the surgeons who are participants in their plans.  The doctors will tell you what the requirements are, but you need to get to the doctors first.

WIth the funded insurance programs the coverage is a bit different than private insurance, so getting the preliminary information from the HMO is helpful.
 So far, so good.

 
mrsbailey921
on 10/25/12 5:19 pm - NJ

hi everyone, i joined this site in hopes of finding information about weight loss surgery, and stumbled upon this thread, which is awesome. like the OP, i too live in nj and have horizon nj health (plan D, which is not AS great as Plan A). i called up tonight to see if i could have weight loss surgery under the plan i have, and the answer is yes. here are the requirements for the surgery under horizon nj health:

- you must have your primary care physician (PCP) agree that surgery is a good choice for you, and they must medically clear you for the surgery.

- you must have recorded at least one non surgical attempt at weightloss within the last 12 months (weigh****chers, jenny craig, lucille roberts, etc.).

- you must have a psychological exam and clearance pertaining to weightloss surgery (to make sure you understand what it is and the effects of it).

- you must be preauthorized for the surgery by Horizon NJ Health. doing the above 3 steps successfully pre authorizes you.

- your PCP must refer you to a participating weight loss surgeon. you then take that referral your PCP gives you to the weight loss surgeon you and your PCP choose (preferably together) to schedule your surgery.

- there are no copayments for the surgery under Horizon NJ Health. the surgery is 100% covered by the insurance company, HOWEVER dietary supplements and devices required after the surgery are NOT covered under plan D. they ARE covered under plan A.

hope this helps! i will be speaking soon about seeing if WLS is right for me.

celticthunder55
on 11/19/12 8:58 am - wharton, NJ

I had gastric by-pass in 2003...the DRS who saved me called it a abdomel castrophie.   I was in a coma for 3 mo. and in the hospital for a total of 8 mo..  I was in septic and volmic shock.  I needed 79 units of blood, was left open for over a year.   well now I have Horzion nj health and need emergency surgery....I have a stricture between the stomach and intestine, gall stones, sludge, an ulcer and adhesions.  I can not fin a surgen to help my gastro dr says it must be a bariatc dr.  I am now can not eat any food at all...living on milk and boost.   good news i am down to 130 lbs up 5 from 2 weeks ago but losing again...someone please HELPdevil

Imamiracle2008
on 11/24/12 12:44 pm - Tinton Falls, NJ

Hi, my name is Danielle and I had my RNY in 2007 and had a horrible outcome also. I was in a coma for 7 1/2 weeks, with ARDS, sepsis, MRSA, you name it I had it, but not as bad as you. I am soon sorry for your situation. I was very fortunate and found this gastrosurgeon who specializes in bariatric surgery out at the University of Pennsylvania in Philadelphia, Pennsylvania. He literally saved my life. They did not think that I would make it and him and his team brought me back. 

You really need to go see him right away. He is a wonderful doctor in one of the too 10 hospitals in the United States. His name is Dr. Steven Raper and his number is 215-614-0382. My husband and I can not stress enough how good he is. I'm also shocked right now that since you can't eat that they don't have you on TPN. That was the only thing keeping me alive at one point. 

Please keep us posted and if you would like to ask me any questions or just want to talk please don't hesitate to e-mail me at danisest@aol.com. Good luck and God Bless. 

Be well,

danielle

'View

mrsbailey921
on 11/23/12 11:11 am - NJ

dr. lennox alves also takes horizon nj health. he is located in west orange nj. 973 243 0290.

mickeysantiago
on 9/23/09 6:01 am - bayonne, NJ
Lap Band on 01/02/07 with
My friend had Dr. Yvan Ducheine he is located in East Orange she had NJ Health. Good Luck.