Any New Yorkers With Health Plus Insurance?

[Kiki Von Moonshine 53]

I want to know your approval wait time. Anyone with any medicaid affiliated insurances?

[Lilu 65]

When I started with health first you have a year to complete everything and most of the requirements are up to the doctors and hospital where you are having it done. It took me a year to get approved by the doctor and had to start over again. So I started again now in Nov. 2011 and my surgery date is for 2/9/2012. I am having it done at Montefiore Hospital

[illgeturhairdid 176]

Lilu, if you get to work with Dr. Appel or Dr. Shah at all (pulmonology) you are blessed. They are two of the best doctors I have ever worked with professionally.

[beba238 123]

I am confused because the nurse practitioner told me health first is the only insurance that doesn't give you any issues especially with the 6 month diet. When i spoke to the insurance lady she told me that i needed the 6 month letter.

[Kiki Von Moonshine 53]

When I think back, the surgeon gave me a sample letter to give to my doctor so when I was done they would submit it to the insurance company, so yes I need a letter. The letter ensures that the doctor saw you, spoke to you about alternate routes (i.e. diet, exercise, etc.)

[D1NOnlySexyLady 70]

Hi Kiki it only took my insurance to approve the surgery two business days. The hospital submitted my paper work on Thursday and that Monday I was approved

[Kiki Von Moonshine 53]

Yea, I hear approval is usually quick, it's getting a date that may take some time. Grrrr...

[D1NOnlySexyLady 70]

This is true! But sometimes other people cancel and your persistent can bring you ahead others,

[Lilu 65]

@ beba238 It is true that thier are limits to some insurance. Healthfirst give you a limit of a year to complete everything and get surgery date. it does not require you to submit a six month weight lose letter from your doctor. But Affinity, Metro Plus and some other ones do require a sim month weight lose letter. The six month letter is to prove that you are having problem losing weight under the supervision of the medical team. If you lose weight on the six month it does not stop you from having the surgery it better for you.

Good Luck

going soon in april Yey

[beba238 123]

Thanks everyone! Now next stop is finding a PCP to send me to my referrals!

[Lilu 65]

@beba238 where are you having your surgery? The doctor who is going to do my surgery was where I got my referrals from to be cleared for the surgery. And I let my PCP know that I was interested in having the surgery. I have cleared all screening and get another date for the last two weeks in april. The last clearence I need is from my PCP and it my not be older than 30 days .

Good Luck

[beba238 123]

@ VST ADDICT.. well i went to my first appointment in December at Columbia Presbyterian. My current PCP has been my doctor for about 8 months and i've only seen her twice and i really don't like her especially because when i told her about the referrals she told me that i had to go to a nutritionist for the referrals (which makes absolutely no SENSE!)

I have referrals (which is a list of all the exams i have to do and the actual referal) but i need my pcp to send me to them because i have no idea where i can get for example an endoscopy. My old PCP I've been seeing her for years and her practice has all those departments but she doesnt take health first. I guess i'll see if i can make these appointments on my own.

How long did it take you to get everything done?

[D1NOnlySexyLady 70]

@ VST ADDICT.. well i went to my first appointment in December at Columbia Presbyterian. My current PCP has been my doctor for about 8 months and i've only seen her twice and i really don't like her especially because when i told her about the referrals she told me that i had to go to a nutritionist for the referrals (which makes absolutely no SENSE!)

I have referrals (which is a list of all the exams i have to do and the actual referal) but i need my pcp to send me to them because i have no idea where i can get for example an endoscopy. My old PCP I've been seeing her for years and her practice has all those departments but she doesnt take health first. I guess i'll see if i can make these appointments on my own.

How long did it take you to get everything done?

Wow that's crazy my pcp was great and while I was seeing her for the six months I would schedule all my appointments, my suggestion is to try to schedule another appointment with a different doctor. I am having my surgery at Columbia Presbyterian aswell

[Lilu 65]

@beba238 in the wlc center is there a cordinator that you can speak to. In montefiore wlc they send you all the referrals for all test need. and give you a list of doctors that you must see to be cleared for surgery. If you really want to see your old doctor you need to find out all the insurance that the hospital takes that are the same as your old PCP. If this coverage is with Medicaid you can change it because you want to stay with old PCP.

It took me about six month to see the doctors but I had some hidden problem and it took me a year to be cleared. But I did not meet the dead line for the insurance and had to start over. It was easier the second time and the wake lost dr. did the endoscopy. I was ready to be sleeve but the anasg. was not sure in her skill and cancelled the surgery. I am now waiting for my new date that will be sometime at the end of april, It would have been earlier but I could not take any more days off of school with failing. So the delay was my choice.

For the endoscopy you need a gastic doctor to order it. Good luck

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