taismommy 0 Posted October 12, 2007 <p>Anyone have HEALTHNET? How did the process work with them?</p> <p> </p> <p> </p> <p>Very overwhelmed and I need all the help i can get</p> <p> </p> <p>Thanks</p> Share this post Link to post Share on other sites
sim78 0 Posted October 14, 2007 I have Healthnet too. I am still in the 6 mounths dr approved diet though. I heard they are really tough. I hope that I don;t have a problem. Good luck Share this post Link to post Share on other sites
taismommy 0 Posted October 14, 2007 Sim, I havent even called healthnet yet to formally ask questions. How is the process going for you? What else do you need besides the 6mths?co-morbidities? Share this post Link to post Share on other sites
sim78 0 Posted October 15, 2007 well since I have just started I am not sure I know that they cover the procedure since I checked out a while back. But it also depends on what state you are in and how big a group your ins is from. MY hubby is part of a huge orginzation and therefore we have things that most people don;t have covered covered on our plan. IT definatly will help your case if you have the co-mobidities. I know that my BMI is very high and I have ohter things that I wouldn;t want to discuss here PM me for me details. My hubby is also going for the surgery and he has not as high a BMI as I do but definatly the co-mobiditites. All I can suggest is to speak to someone give them the CPT code see what they say. I know that sometimes that they will tell you about certain things that they need which could help you get the approval that you need good luck and I hope that this helped you. Share this post Link to post Share on other sites
DaBlockzPRbabii 30 Posted October 18, 2007 i as well have health net common wealth care by BMC (boston medical center) i have been looking up information as to wheather they cover or not and they do cover bariatric surgery only if its medically necessary im not sure if its only bypass or not but the lady on the phone asked for a specific produre and i told her the lap band. I was told any written information i needed about the policy itself would be in the evidence of coverage booklet on page 28. that doesnt help because it doent specify bariatric surgery . Personally i dont think that was accurate information. i would love to keep in contact about your progress through all of this process Share this post Link to post Share on other sites
taismommy 0 Posted October 18, 2007 Pereza211, I spoke to HEALTHNET and i was told that the lapband surgery is covered but you there are several things that have to be done before they pay. The lady i spoke to sounded unsure and put me on hold several times and i really didnt have time(i was at work)to keep getting put on hold again. I told them that i am going to call back later Share this post Link to post Share on other sites
DaBlockzPRbabii 30 Posted October 18, 2007 i have founf usefull information on my own do you have boston medical center health net plan? im not sure if were under the same plan i live in massachusetts if you are here is what i found on the policy and guidelines: go to bmchp.org click on providers up at the very top from the left side menu look for "provider e-services" its the 2nd to last link on the list after you click on that look for policies once it unfolds click on "clicnical coverage" from the main page now scroll down until you see "surgical" in bold the second link on that list is the Bariatric surgery link i hope we do share the same insurance in the same state it would be nice to have some one to refer to. Good luck Also if it helps any the lady i talked to also put me on hold serval times before she even had a clue what was going on. i hope i have helped. Share this post Link to post Share on other sites
taismommy 0 Posted October 18, 2007 perez, i have HEALTHNET northeast, i looked at the website you suggested i dont think that our coverage is the same. But I would love to keep intouch, it seems that we are at the same stage of the Lapband search. Tamika Share this post Link to post Share on other sites
DaBlockzPRbabii 30 Posted October 18, 2007 absolutly! i have my intial consult on 11/13 two days after my birthday. I hope i get a great late birthday present to myself. Share this post Link to post Share on other sites
taismommy 0 Posted October 18, 2007 you know what? all this research that ive done and i narrowed it to 2 doctors, now im scared to make the appt Share this post Link to post Share on other sites
DaBlockzPRbabii 30 Posted October 18, 2007 have you attended a information seminar? They offer great information. You should make the appointment. The doctors office is where you should ask all the important questions to minimize your fears and worries. They will go over EVERYTHING that you should consider and need to know with you before hand. This is a big step you should consider your options and talk it over with your family. good luck Share this post Link to post Share on other sites
taismommy 0 Posted October 18, 2007 i know that im doing this, i have no idea why im scared now? its weird. my mother had a gastric bypass and i went through some if it with her at the end(she didnt tell anyone until she had a surgery date) Im going to call and make my appt tomorrow with Dr Herron. There is a seminar next Friday at 8am not far from me. I can goto that and be late for work Share this post Link to post Share on other sites
MariMari 0 Posted November 4, 2007 I have healthnet, but unsure of how my insurance works. I am a newby and need all the info I can get on how to go About getting this surgery..? Did your doctor approve it? Share this post Link to post Share on other sites
DaBlockzPRbabii 30 Posted November 5, 2007 where are you from? i live in Massachusetts and i dont think we have the same insurance. Share this post Link to post Share on other sites
Jen93003 0 Posted November 5, 2007 Hi everybody!! I have HealthNet and haven't had a problem. Thank God! I was banded on 10/9/07, they paid for everything. My primary referred me and the referrals started pouring in after that. I live on the West Coast and I work for the county in my city. I had to travel to USC to get my surgery but all was worth it. With all my struggles with the adjustment to eating smaller and being on liquids for the first 2 weeks after surgery I finally had my first post-op appt and was pleasantly surprised to have lost 33lbs!!! I am so motivated by that alone! Good luck to all!:whoo: Jennifer Share this post Link to post Share on other sites