Horizon Healthcare anyone ???

sparkling · February 28, 2006

Heya Everyone !!! I'm new to the board just curious to see if anyone knows about Horizon Healthcare... I got a date and very nervous about insurance coverage ... Good luck everyone !!!

Alexandra · February 28, 2006

Are you talking about Horizon BCBS in New Jersey? Or Horizon in New York?

Either one is pretty band-friendly, as long as you qualify medically. Where are you in the process?

sparkling · February 28, 2006

Thank you so much for replying. Right now I have a surgery date 3/23. I have a psych evaluation today. And thats it ! I have horizon Healthcare in NY. Have you heard of them accepting the lap band. I am soooooo nervous.

gviscio · February 28, 2006

You're fine. If they deny, just appeal, the State of NY is very good to deal with.

sparkling · March 3, 2006

* very happy Horizon approved me *

sweetness1 · March 31, 2006

Just wondering if anyone has had a problem getting approved fro banding?

Have BCBS PPO direct access nj

Thanks,

MArgie

sparkling · March 31, 2006

I'm in NY. I have horizon healthcare which I dont think they are bcbs.. I was approved within days they are awesome

Alexandra · March 31, 2006

Horizon is BCBS, and yes, they are very band-friendly. If you're medically qualified, Sweetness, you should be golden!

sparkling · March 31, 2006

Didnt know they were BCBS thanks !! And they were quick to respond.. Offhand do you know how they handle fills ?? Thanks again for all your advice

Alexandra · April 1, 2006

Sparkling, generally speaking if the surgery was covered then fills are covered, at least to a certain point. (One year? Five adjustments? It probably varies.) Fills are an integral part of the overally treatment, and if the treatment was approved they will be too.

But each carrier has its own procedures. Your doctor will know precisely how to code the procedure and submit the claim for maximum coverage. And I'll bet a lot that he has an insurance specialist just for that.