Horizon NJ Direct 15

[taylokat 180]

I finally got the nerve to call my insurance company to see if I was approved. They said as long as they receive the letter of medical necessity, it's a covered expense, so no problems! I'm amazed how easily it was!

[elhudge 69]

Who did the letter have to come from? Your PCP or the surgeon?

[taylokat 180]

My PCP. My surgeon has a pre-filled form stating all the key words needed and all my PCP had to do was fill in my co-morbidities (only sleep apnea) and sign the form.

[elhudge 69]

Oh great!! Im waiting for my consult. I have NJ DIRECT too. No supervised diet?

[junkfoodartist 4]

I'm waiting to hear too, I also have Horizon NJ Direct and my research had told me that they don't cover sleeve, say it ain't so!

[taylokat 180]

It ain't so! They do cover. I had to list all of my attempts to lose weight, the weight I lost and regained. I saw the surgeon on Jan 20th, he gave me a list if things I needed to do...psych consult, GI consult for EGD, medical clearance, cardiac clearance and pulmonary clearance and he sent me for a sleep study since I had no other co morbidities and my BMI was 37. I was positive for sleep apnea so that's why I was approved.