Do your insurance companies know you had LapBand surgery?

[jodi]

I'm very interested in having this surgery in TJ or Cancun. One of my concerns is what happens if there is an emergency and I have to be treated locally---for emergency surgery, for an unfill...whatever might come up. Do your insurance companies know about you being banded and will they cover costs for complications?

Jodi

[Kari]

I had my surgery in TJ with Dr. Ortiz. Paid cash and then submitted all the info to my insurance company. I qm not sure what they are going to do with it since they want more info, including pre=authorization. But, I found a doctor here that will do fills and he is an innetwork doctor and my insurance is paying for my fills less my co-pay.

[jerseygirl]

I had my surgery in TJ with Dr. Ortiz. Paid cash and then submitted all the info to my insurance company. I qm not sure what they are going to do with it since they want more info, including pre=authorization. But, I found a doctor here that will do fills and he is an innetwork doctor and my insurance is paying for my fills less my co-pay.

am surprised that your insur will cover fills...what insur? I have aetna and was not planning to tell them I had it done since they didn't pay for surgery. Any thoughts?

[Dolittle]

I had my surgery in TJ with Dr. Ortiz. Paid cash and then submitted all the info to my insurance company. I qm not sure what they are going to do with it since they want more info, including pre=authorization. But, I found a doctor here that will do fills and he is an innetwork doctor and my insurance is paying for my fills less my co-pay.

I did the pay cash, have the surgery and I submitted it to my insurance provider (UHC). I got a "They ain't going to pay" letter from them stating I didn't get pre approval first. I'm now in appeal. My appeal had to state that it was imposible to get pre approval cause no one in my area even did the lap band surgery. I also had contacted them at the beginning of my lap band adventure and they could'nt tell me how I could get pre approval. Insurance companies are like talking to a wall. LOL. It's like dealing with the people in the comic strip "Dilbert"

[xoxo]

I am with Jerseygirl!

I am not telling my insurance company but KARI if you sent in papers afterwards and they denied it but are still covering fills...interesting. Where do you live?

When you look in your provider directory what is the specialty of the provider? You aren't using a Fill Center? :-?

[FurEllie]

I submitted a claim with them since many here are being reimbursed. Haven't heard anything back yet - thanks for reminding me I need to contact them!

They just paid all my medical bills when one of the items was removal of the band so yeah, besides me filing the claim, they know.

All insurance companies are different so read your contract with them. Usually getting care outside the network isn't against their "rules".

[Kari]

Hi

I'm from Michigan and I have Mi Blue Cross Blue Shield, through Teamsters. The doctors I go to are surgeons, DOs. Don't ask me why they cover fills, the office said they would submit the claims and wait and see. They paid. I haven't gotten around to getting the info they want for my claim. I've been putting it off because to me, since I don't have all they want, it is more of an appeal and just haven't done anything yet.

the last newsletter, I got from teamsters did say that they will no longer cover doctor and hospital bills for complications from unauthorized or non-covered surgeries. So, let's pray I don't have any complications.

[restrict2008]

I have BCBS and they wont cover my surgery or any complications from it---

I too am scared that something might go wrong and need emergency surgery- I would be required to pay for everything.

Ask your insurance company specifically if they have any exclusion criteria