NEED ANSWERS ! NEW JERSEY

[Brittany Paige 1]

Excuse me if I'm being repetitive, but its really bugging me ! Again, as my annoying self has posted in 1392846 posts, I have Horizon NJ health (Plan A, family care) I plan on going to Dr.Neff. However, my insurance says there is a 12 month nutritional program required, but others have told me (including the insurance specialist with Dr.Neff) that this is not the case and they have never heard of this. I just need some definitive answers, from others who have this insurance RECENTLY, on if there is or isn't any type of x amount of months nutritional program required. I could have all my tests done by the end of March. Can someone please give me their experience with this insurance from New Jersey who has used Dr. Neff ? It would be so greatly appreciated. Im going crazy !

[Elizabeth21 176]

Have you tried contacting your insurance company directly or looking at your plan/policy? It is probably available online.

Good luck!

[samuelsmom 670]

If the insurance company has a web site you should find their book with all of the coverages and requirements. If not, call the insurance company back and ask for the bariatric surgery policies in WRITING. Good Luck. It is never fun wading through insurance requirements.

[deedee52504 0]

Hi I'm in hudson county nj i have the same ins you have the only thing they asked me to do is 2 support group classes and i indvidule onewith a nurt. that all got approved in 3 months write them a personal letter why you want the surgery good luck Denise

[linzlou2000 193]

I have BCBS through the State of VA. I have a 12 month program also.

[linzlou2000 193]

My member book/benefits is online in a PDF file. It clearly outlines the program and what must be done to qualify. I wish it wasn't 12 months!!! My PCP and surgeon both states it is unusual to have such a long program. It is what it is. Now I have to play by their rules to have it covered.

Edited March 1, 2015 by linzlou2000

[jgwald 2]

I also am going to Dr. Neff. I have Atena and have followed the check list they give you and I only have to make Four(4) visits with the nutritionist. They want you to get approved and I would call the insurance company and go over Dr.Neff check list with them so you do not miss any steps.

[Susan66 128]

Begin with the Dr and their insurance specialist will contact the insurance company to try to get you pre-approved.

[Thinny 30]

Loopholes...does it have to be 12 consecutive months. Does all The times you tried to lose with you doctor count.

[tamlalynn 13]

Dr. Neff and his staff are awesome. They took care of my sister. Call them for clarification

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[Mary2016 55]

I don't have an answer for you, but I wanted clarification on my insurance qualifications as well. I called Aetna to ask about the written guidelines and they told me they can't answer my questions, it is up to physician discretion and interpretation. I am using one of Dr. neff's partners, Dr. Adam Goldstein. He is great, but it's hard to get in touch with the coordinator to discuss the insurance stuff. Just venting. Really want to clarify some things.