Horizon NJ Health, 12 month wait?

[myfatisnotaflaw 33]

Hello all, I am new here. My PCP broached the subject of bariatric surgery recently. I am pretty interested. Has anyone dealt with this insurance company recently and bariatric surgery? When I called they told me the first step is to do 12 months of a documented weight loss program before anything else related to surgery. Timing wise, I found this a bit discouraging- as I have time intensive goals next september. Anyone have experience going through Horizon NJ Health? Thanks.

Hey! Thanks for starting this thread girl. Since last night I've been reading about your journey through this board and you and all of the other ladies were AWESOME help! Thanks so much and congrats with everything!

[myfatisnotaflaw 33]

Hi everyone. I have been reading all of the post since its inception in 2013. So many of my questions have been answered. I'm currently seriously considering the lap band. I noticed the doctor who I am trying to set up an appointment with Dr. Goldstein was mentioned a few times here. Please continue to keep us informed. Thanks ladies!

[mrsbailey921 117]

@@myfatisnotaflaw welcome! yes, i lurked in this thread for MONTHS before my surgery, probably since it began. it is by far one of the most helpful and was a catalyst in me deciding to go forth and have the gastric sleeve. awesome thread, awesome ladies and awesome doctors. congratulations on your journey and all the best.

[mrsbailey921 117]

and there is no 12 month wait for HNJH lol, at least not anymore (not sure if there ever was one).

[myfatisnotaflaw 33]

Awesome... I have my first consult Tuesday. I'm nervous & excited at the same time. I thought I was pretty sure on which procedure I wanted but the more research I do the more confused I am. Lol

[mrsbailey921 117]

If you have about 100 pounds to lose I think the sleeve it's a great choice. If you have more than that to lose I would consider bypass, but for me bypass was a bit too much.

[Angelkeeper4 69]

I agree MsBailey. I have close to 200 to lose which is why I'm choosing bypass. On my preop diet now surgery in 9 days!!!! After waiting 13 years 9 days seems surreal

[myfatisnotaflaw 33]

I'm looking to loose about 115 to 150. I'm sooo afraid of the sleeve. I can't cope with knowing most of my stomach will be permanently gone. And bypass is out of the question. I'm liking the band because its reversible & faster recovery but I'm afraid it may not be effective fast enough.

[mrsbailey921 117]

To be honest, many banders wind up revisioning to the sleeve anyway. One of my good friends is banded, lost 130 lbs in a year, and is now considering sleeving to make it permanent. My issue with the band is that it is not a permanent procedure. I didn't go through all of the difficulties just to place a band on my belly that may break in a few years, or become less reliable as time goes on. I wanted a lifetime change, one and done! The sleeve gives me that. And I still have my stomach...nothing has changed much. I still get cramps from drinking cold liquids in the am, just like I have since I was a child. I still have a stomach made of Iron, just like before. I still get nervous in my belly, I'm just getting over a stomach bug and I still got the bubble guts lol. Nothing has changed for me, except my stomach is smaller.

[mrsbailey921 117]

Angel, the choice is definitely unique for each of us. I didn't choose bypass because I only have 100 to lose, and I didn't want to deal with food restriction and nutrient restriction/malabsorption. But that's probably because I only have 100 to lose. But many, many people are successful with both the bypass and the band! You can do it!

[Angelkeeper4 69]

MsBailey well said. I'm choosing bypass because I have 200 pounds to lose and I want one and done.

My surgery is Monday!!

[myfatisnotaflaw 33]

Oh OK...I understand

[mrsbailey921 117]

MsBailey well said. I'm choosing bypass because I have 200 pounds to lose and I want one and done.

My surgery is Monday!!

congratulations!!! let us know how it goes (today)!!!

[purrfctangel 239]

Glad i found this post! Had UHC in Baltimore but after three months of doing nutrition, consults and some tests i had to move back to NJ after 20 years. Started again with Dr Attia, nutrition and tests. Will be on NJ Horizon starting 1/1/15 and we will submit as soon as i get my info. Glad to hear they approve quickly. Sounds like i will need letters from my PCP, ortho surgeon and maybe previous bariatric in Baltimore. What a complicated mess. Just want this to be part of my total safe fresh start. Thanks for all the info! Nice to hear from others!

[Catherine Gray 11]

Hello everyone, I am new here :-). I started my process 1 1/2 years ago, got prgnant on the pill, had baby, and picked back up in september. Ive gotten all my clearences and evals done. As of 2 weeks ago, my surgeon sent everything to the insurance company. I have BcBs as primary (they do not cover surgery) and horizon nj health as secondary. So ill post some helpful info.

Surgeon :Dr. Chris Boynton, Lumberton NJ 609-267-7050

insurance BCBS PPO, (PRIMARY), HORIZON NJ Health (Secondary)

Psych Consult: Diane Palmer, (Kennedy Health systems, Stratford) I will post the number when I find it. Consult was 100% covered with HNJH. No out of pocket expense

Nutritional consult: Virtua Dieatary, 100% covered. Bariatric Nutritionist was through the Dr's office. HNJH would not cover, so office charges $35, one time :-)

Bariatric Nurse: Chris Aroglia, she is awesome!!!!!!!!!!! She's ontop of everything and is always reachable.

The hospital is Virtua Mt. Holly

I am currently waiting for my primary to deny, so tgat it can be sent to secondary. I will update on how long the approval process. Otherwise it was 3 visits, all your necessary clearances, 2 nutritional appointments, and my PCP referral. Hope this helps :-)