Are Fills Covered by Insurance?

[Dawn NH 0]

I am being banded on 12/13 and called my insurance to see if fills are covered. It seems like a no-brainer to me if they pay for the band, they should pay for the fill. Well it seems that there is not a clear answer to that. I was told that there is a pre-certification process and there is no guarentee that it will be covered. So I am wondering if people are paying for fills or if they are covered, I have Cigna insurance and my dr charges about $250 for each fill.

[HotLikeHer 0]

My Dr Charges 600 for the fill to my insurance company, it is billed as a surgical procedure. I end up paying 72 for it after the insurance pays the negotiated rate since they are on my plan...

[piercedqt78 658]

I was told that fills would not be covered. My doc does them under flouro and list it as a diagnostic test with injection and it was covered 100%. It depends on how it is billed and also how the policy is written. ~Mandy

[Alexandra 55]

Mandy is absolutely right. It ALL depends on how the claim is filed. Your doctor should be able to tell you if he has successfully filed claims for fills in the past.

[Dawn NH 0]

My doctor has not billed yet other than the 90 days after surgery code. They were able to give me the code and I checked with my insurance, I am just concerned that they can reject the claim. It seems silly that the insurance would approve the band, but not the fills. Everything I have read is clear that the fills are very important to the band being a successful tool to lose weight. Thanks for sharing!!! It is very helpful to know what others are doing.

[terriann50 0]

My insurance covers my fills and my dr charges $600.00 to them also. I only have to pay my $15.00 copay.