New Here.. Insurance question - ThinnerTimes

dutchgirl · 02-06-2006, 05:04 PM

Hi;
I'm new here and had a question about insurance. My husband is about to choose our insurance with Health Net-either PPO or HMO or POS. Anyone have experience with this insurance in Southern California? I have an appointment with a Dr. near my home, but I don't know if he's contracted with Health Net. I can find that out by calling I know. If someone knows Health Net's preferred provider for bariatric surgery in the area, I woulod greatly appreciate knowing so I don't go to a physician who is not contracted and I have to incur an initial visit cost.

Thanks!

twodogsmom · 02-06-2006, 05:42 PM

Call your local hospital, ask who does bariatric surgery in the hi desert area. Then call their offices and ask if they accept Health-Net. Or, call Health-Net and ask who are bariatric surgeons in your area. Your husband should have received a list of providers from his personnel office.

D's Hope · 02-06-2006, 06:12 PM

My employer offered HealthNet with all of those, HMO, PPO and POS. I quickly found out that only the HMO portion would cover this procedure since I had it as an option with my group. The one thing I had a hard time doing was finding the proper medical group (IPA). I am just down south from you in Sherman Oaks, so if I can help you with choosing and IPA and surgeon that I know takes it, drop me a line.

Hope

Sweetgirlinsd · 02-06-2006, 06:27 PM

Yeah I have Health Net POS.. which i guess it means i have HMO or PPO.. whatever route u chose to take. Anyways i decided on a surgeon and figured he was the provider, did everything, and was ready to turn paperwork in, found out he isnt the provider for health net (so i would have to pay 30% of whole surgery- including hospital fee), so i decided i cant do that. Health net told me who their providing surgeon is for this surgery which is around my area. Just call health net and ask them for a providing surgeon for the gastric bypass (or just bariatric surgery). Just remember HMO may take a little longer for approval but they pay for it all. Although PPO may get u in and out faster, you have to pay some. Good luck!

D's Hope · 02-06-2006, 06:31 PM

My timing was wonderful, from the time I switched IPA's, saw my PCP, did all my tests, it was just 6 weeks. If you get an IPA that does its job properly it works great. My cost was just $250 for the hospital stay. Just do your homework and find out which option you would benefit from, if it takes just a little longer than having to pay 30%, then I think its worth it.

Just my few more cents.

Hope

dutchgirl · 02-07-2006, 10:01 AM

Wow, this is good to know....

Yes, Hope, if you could give me the name of the IPA and physician you used
I would appreciate it. Did Health Net give you the name of the bariatric surgeon? Alsowahat pre-requisites are they having or had you do?