Pre op instructions for emblem health NY

[harley_quinn25 80]

Hi,

I'm new here and I have read a few boards and I see everyone is beyond helpful in some way. I'm 25 years old and live in Westchester, NY. I went for my seminar December 10, 2014

And have my first appointment with the surgeon January 23☺️was wondering for those in NY with emblem health how long after your first appointment did you get a date? What are the pre surgical requirements that need to be completed beforehand? Thanks so much!!

Edited January 18, 2015 by harley_quinn25

[harley_quinn25 80]

Any info would be helpful. THANKS IN ADVANCE

[Sharon1964 2,530]

What are the pre surgical requirements that need to be completed beforehand? Thanks so much!!

Your best bet is to call the customer service (or member services) number on your insurance card. Ask them what their requirements are for approval for weight loss surgery. Write down the date, the time, the number you called, and the name of the person you spoke to. Write down your questions and their answers.

Some of your questions should be:

1. Does my policy cover weight loss surgery of any kind?

2. Are there certain types of weight loss surgery that are covered and if so what are they?

3. Are there any types of WLS that are specifically excluded?

4. Do I need a psych clearance?

5. Do I need a period of time of medically supervised weight loss appointments, and if so, how long?

6. Do I need any other clearances?

7. What are the BMI requirements?

8. Do I need to have any comorbidities for it to be covered?

9. What is my deductible? (amount you pay before insurance pays a cent)

10. What is my copay?

11. What is my maximum out of pocket? (the total amount you will spend in a year on medical care and then insurance will cover ALL of the rest)

12. Is the psych clearance (if you need one) covered by my insurance?

13. Is my surgeon in my network? And if not, what does that mean to me financially?

14. Is my hospital in my network? And if not, what does that mean to me financially?

15. Is my anesthesiology group in my network? And if not, what does that mean to me financially?

Good luck.

[harley_quinn25 80]

Your best bet is to call the customer service (or member services) number on your insurance card. Ask them what their requirements are for approval for weight loss surgery. Write down the date, the time, the number you called, and the name of the person you spoke to. Write down your questions and their answers.

Some of your questions should be:

1. Does my policy cover weight loss surgery of any kind?

2. Are there certain types of weight loss surgery that are covered and if so what are they?

3. Are there any types of WLS that are specifically excluded?

4. Do I need a psych clearance?

5. Do I need a period of time of medically supervised weight loss appointments, and if so, how long?

6. Do I need any other clearances?

7. What are the BMI requirements?

8. Do I need to have any comorbidities for it to be covered?

9. What is my deductible? (amount you pay before insurance pays a cent)

10. What is my copay?

11. What is my maximum out of pocket? (the total amount you will spend in a year on medical care and then insurance will cover ALL of the rest)

12. Is the psych clearance (if you need one) covered by my insurance?

13. Is my surgeon in my network? And if not, what does that mean to me financially?

14. Is my hospital in my network? And if not, what does that mean to me financially?

15. Is my anesthesiology group in my network? And if not, what does that mean to me financially?

Good luck.

thanks so much! I will be calling on Tuesday.

[Idonerds 136]

Hi,

I'm new here and I have read a few boards and I see everyone is beyond helpful in some way. I'm 25 years old and live in Westchester, NY. I went for my seminar December 10, 2014

And have my first appointment with the surgeon January 23☺️was wondering for those in NY with emblem health how long after your first appointment did you get a date? What are the pre surgical requirements that need to be completed beforehand? Thanks so much!!

I have emblem and also live in Westchester... they require 4 months of pre surgical appointments with nutritionist and psychiatrist. Depending on your BMI you may need to have comorbidities... but it's best to call l...good luck

[harley_quinn25 80]

Thank you so much! So it took you 4 months to get a date? Did you do your surgery already? Maybe we can be surgery pals

[Idonerds 136]

Thank you so much! So it took you 4 months to get a date? Did you do your surgery already? Maybe we can be surgery pals

Yes... and it took about a week for the surgery to be approved by the insurance company maybe less I just checked back a week out... my dates is surgery date is February 3, I had to arrange some things for work. Sure what part if Westchester are you in

[harley_quinn25 80]

Wow! Congrats!! I'm in yonkers the non Burrough Lolz I know some insurances make you do a weight loss thing first and that's what I'm afraid of because if I could lose weight without surgery I most def would

[Idonerds 136]

Wow! Congrats!! I'm in yonkers the non Burrough Lolz I know some insurances make you do a weight loss thing first and that's what I'm afraid of because if I could lose weight without surgery I most def would

As long as you stick to the plan the nutritionist gives you.. You will lose some weight I lost 15 lbs during that time but as long as you don't gain you should be good.... I'm in mount Vernon

[harley_quinn25 80]

Oh you're not that far at all. Yea I'm hoping they give me a sooner date Lolz

[Idonerds 136]

Where are you getting your surgery?

[harley_quinn25 80]

Where are you getting your surgery?

The Bronx how about u

[Idonerds 136]

The Bronx how about u

Nyu