Horizon NJ DIRECT 10

**Startinganewlife** · 05-29-2016 08:06 AM

Hiii
Im very thankful for everyone who posts on here as I have read ALOT of them and they are so helpful.. I was researching and trying to find our what my insurance would cover for NJ DIRECT 10 and what the requirements were. I called my insurance company and told them I had letter of recommendation from my Primary doctor and they were nice but vague and said My surgeon was the one who called the number on the back of the card and they give THEM the list of requirements and she said "its not as easy to just get a letter from the primary doctor and that's it" & basically shut me down. The not knowing if I'd need the 6 months of documented weight loss programs (I have a lifetime that are NOT documented, over the years tried and failed programs THANK YOU!) and all the other requirements would weigh heavy on my mind again through the night.
When I hung up the phone I felt even more anxious... the next morning I decided to call again after all it is my right to know I pay for the insurance ~I should have the right to that information- after pumping my self up for the debate I called again... this time a young women answered the phone I told her the reason for my call and didn't even get a chance to argue my side before she said "you sound upset and let me see if I can help answer all the questions you have...." (now that was a change) she said the surgeon is the one who calls the number the doctor has a series of things he needs to complete... One being that a 6 month documented loss program is NOT one of them ..wheww! and you would have to get clearance from a pulmonologist ,cardiologist, psychiatric clearance and Gastroenterology all of which they had recommendations for or you could use your own.. they scheduled my appointment that DAY and my surgery is Aug 4 pending the doctors appt all go well. I sat with the surgical coordinator that same day who said my surgery was covered and my letter from my primary was NOT needed either. My point is don't stop at one call, think it over and CALL BACK and get the answers that you seek...and if one of the them is not what you wanted to hear DONT STOP keep going!!! It's a journey not a night out- YOU GOT THIS!

**WANAGL** · 05-29-2016 12:40 PM

Welcome!

Your "DON'T STOP" message is a great message!

**Startinganewlife** · 05-29-2016 02:20 PM

I can only hope to have results like yours ~ Thank You

**sugarmag** · 05-30-2016 07:24 PM

I have the same insurance and didn't even call. My surgeons office told me everything the 2nd call told you. I am almost through all my testing, I have 2 left and so far all is a green light. Did you happen to ask about post surgery plastic surgery? Where is your surgery? I am scheduled for 8/23

**WANAGL** · 05-31-2016 09:43 AM

Originally Posted by Startinganewlife

I can only hope to have results like yours ~ Thank You

You're welcome!

Your results may not be exactly like mine. I really wanted to change my lifestyle, and I am willing to go to any lengths to do just that!

You can do it too!

I read profile posts of veterans like tinman, ann2, kindle, jerzeygirl, aydensmomma to name a few. And of course I follow my Dr's instructions.

Best of luck as continue your journey!

**Startinganewlife** · 07-15-2016 07:03 PM

Hi sorry for my late response ~ when I called my surgeon I couldn't get into his office for two weeks which left me with so many unanswered questions and what hoops I would have to jump through so I kept calling my insurance company ... 2 more tests almost there !! I can't wait ~ my surgery is August 4th ��
Best of luck to you and your new journey!