Kind of bummed

[BarrCarr 3]

Hey guys. I haven't posted much but I have been ghosting. During my journey to actually getting my surgery (4 months so far!) I've been reading all of the posts on here and they've all really helped me get by.

But today I kinda got bummed out.

I've been working with the NJBC for the surgery and what I was told was that after I fill all the requirements for them and make 4 visits with them (one each month) I'd be able to schedule the surgery. My last requirement was met last Tuesday, and my last visit was the following Thursday. I was told that my navigator would call me with my scheduled surgery and she did. She called me about a half hour ago and told me that she just spoke to my insurance (I have 1199-Aetna) and that they have different requirements in order for me to be scheduled for the surgery.

Basically the only requirement is that I do a 6 month diet. Now like I said before, I've been working with NJBC for 4 months now. My navigator says that all I have to do is make two more appointments (one in January and one in February) and then I can be scheduled.

Now what bums me out is not that I have to wait an extra month and a half. But that I feel like no matter whether or not I make these appointments, my insurance company is going to wind up saying that I have to start all over and do the actual 6 month diet. Because that's what they're looking for, right? I mean my navigator really just sounded like she was saying " ok 2 more visits and we'll see if they'll accept it".

Ah idk, did anyone else have an issue like this?

Also let me not leave out that during these 4 months I've actually gained 8 pounds and was told to just not gain anymore or lose anymore by my nutritionist.

Yeah lol I just really need some reassurance that I'll actually get this surgery instead of being misled.

Trust issues- if you haven't noticed haha.

[JerseyGirlJodi 16]

Hi there! Are you at the office in Springfield, Hoboken, or Somerville? I go to the one in Springfield. I started this process three months ago. I have Aetna at the moment, but my company is switching to United Healthcare as of January 1. I was told that for Aetna, the requirement was 4 months of visits. I wonder if different Aetna plans have different requirements? Shouldn't the Navigator have known that from the start (that's basically their job, no?).

For me, I have three months down and since I switch to United Healthcare next month, my requirements change from 4 to 6 months. I was told by my Navigator that I don't have to start over new. That United Healthcare will accept the three months I've already done. I would think that if your requirements changed from 4 to 6 months, that it would only mean 2 more months. Not having to start all over again.

[Shan1383 0]

My sister and i are having our surgery next month by Dr. Nausbaum. His office is in Livingston but we are having it at Morristown Hospital. We have Oxford and we were also required to do six months with a nutritionist. Next week will be the end of the six months and then they will submit all the paperwork back to the insurance company. Oxford/UHC is the same company so i know alot of their policies are the same. Hopefully we will get a surgery date soon. I don't find alot of ppl from nj on here so im happy to have found you.

[BarrCarr 3]

Hi there! Are you at the office in Springfield' date=' Hoboken, or Somerville? I go to the one in Springfield. I started this process three months ago. I have Aetna at the moment, but my company is switching to United Healthcare as of January 1. I was told that for Aetna, the requirement was 4 months of visits. I wonder if different Aetna plans have different requirements? Shouldn't the Navigator have known that from the start (that's basically their job, no?).

For me, I have three months down and since I switch to United Healthcare next month, my requirements change from 4 to 6 months. I was told by my Navigator that I don't have to start over new. That United Healthcare will accept the three months I've already done. I would think that if your requirements changed from 4 to 6 months, that it would only mean 2 more months. Not having to start all over again.[/quote']

I would have thought that the navigator would have known but I'm guessing because Aetna does do the 3 month requirement she wasn't aware that 1199 (which is part of Aetna? Idk how all that works, )apparently has a 6month requirement. Yeah I'm just worried now that the fact that I've gained weight instead of loss with be a big issue. Part of me wishes I had done this whole thing earlier in the year. This time of the year I always wind up gaining weight due to the holidays and winter.