Question:
Hello from NJ....first question.....please help....
I have a question concerning obtaining approval from insurance company. I have Horizon Blue Cross Blue Shield of NJ HMO. I recently had my first consult with a DR. in New Jersey and have a surgery date set up for November. Only problem is, I'm waiting for insurance approval. Being that I am only 22 years,(318 lbs), I don't have years of diet failures under my belt. I've tried Meridia, Xenical, Slimfast, Dexatrim, Nutritionist help, low fat diets, exercise, and still no weight loss. Naturally I am worried insurance company will deny me based on the fact that I don't have dr. assisted diet history. Please help! Naturally I am pulling my hair out in worry.!! Thanks. — Jamie W. (posted on September 15, 2002)
September 15, 2002
Jamie,Some of the Insurance CO only want the past 12 or 18 months history
info from your Dr. Since you were on Meridia, have the Dr that prescribed
it write how you did on the medication. Also, the Nutritionist info would
be good. Try to think of all the Medical problems you have had due to the
weight..Arthritis, Joint Pain,Shortness of Breath,High Blood
Pressure,trouble Sleeping, etc. Good Luck let us know how you come out.
Nancy Poe
— NANCY P.
September 15, 2002
Hi Jamie! I have Horizon BCBS of NJ Direct Access and had no problem. I
was approved with in 10 days. I did not have any medically supervised
diets, just a long list of self imposed ones and that seemed to be enough.
Good luck!
— jerzeygirl71
September 15, 2002
Jamie -- I had my surgery on July 31st -- same insurance, no problem at
all. I had diet failures to list, but nothing doctor supervised. You'll
be fine! Good luck.
— Jennifer W.
September 15, 2002
Jamie- I have Horizon NJ Plus and I got approved in a week. I just listed
the other diets I had tried and they approved it no problem. The things
you listed were the ones that I had listed as well. As far as being too
young, that shouldn't matter. Good luck to you. - Mike
— Michael N.
September 15, 2002
hi there :) i had bcbs of illinois and i had told my surgeon everything i
had done in the past to lose weight. i.e. jenny carig. weight watchers,
dietician, my own diets. he jotted all of this down. it was never an issue
with the insurance company, they never asked me to prove anything and i was
approved in 1 week. i started at 5 9 370 had open rny on feb 8 02 and im
now 230 WOOOHOOO! i love that i had this! best of luck to you.
— carrie M.
September 16, 2002
Hi Jamie. If you've tried Xenical and Meridia -- there is a doctor
somewhere with this information in the files as these are both prescription
drugs. Payment Receipts or paperwork from the nutritionist will support
your claim there. I did not have to produce evidence -- my PCP took all of
the information I gave him about my various weight loss attempts and put it
in the paperwork that went on to the surgeon. That's all BC/BS PPO
required of me. Best of luck!
— Pam S.
September 19, 2002
Thanks to everyone who responded to my question. I got my approval today!!
yahoo!!!
— J. W.
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