Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Are Fills Coved By Insurance?



Recommended Posts

I have Empire BCBS and got approved for surgery but not sure about fills? What the normal policy on this if you insurance does cover the surgery??

Share this post


Link to post
Share on other sites

I have BCBS-IL, which I think would be similar and I went round and round with them before I finally got an answer to that question. The answer was that the surgery was approved as medically necessary, therefore any and all "maintenance" required would also be covered.

My surgeon covered 2 months, but the third month got submitted to insurance, and never got processed. My surgeon billed $650 for the fill, and I flipped out at the thought of having to pay that monthly. It turned out it was a "glitch" in the BCBS system, and it ignored claims from my surgeon. My surgeon was fine with waiting - but I was freaking out! I've got my next fill on Tuesday, and I had to demand an answer before I go, cause I can't afford it otherwise. Once it finally got reviewed, they only allowed $410 - but that's still not something I could absorb monthly!

Share this post


Link to post
Share on other sites

I have anthem BCBS, and when I called to ask about my bariatric benefits, they sent me a statement which also said fills are covered. I am guessing the fills are at the 20% policy, unless you've already paid your max out of pocket for the year.

Share this post


Link to post
Share on other sites

I have BCBS Fed. My surgeron said everything from 3 months after surgery is included in the surgery insurance claim. He said after that I would just be responsible for my co-pay ($25) per visit.

Share this post


Link to post
Share on other sites

I have Medicare and they covered the first year of fills. Now I have to pay for them ($160) each. I only go in about once every 6 mths now, so it's not too bad.

Marci

Share this post


Link to post
Share on other sites

wow! I didn't realize the fills were that much money!!!!

Share this post


Link to post
Share on other sites

BCBS CA Access+ H M O here, after the first year, I just need prior approval for fills and visits to my surgeon. Other wise, I am covered. Approvals take about a week.

Share this post


Link to post
Share on other sites

I have to say that I LOVE my insurance, they cover my fills with just my $20 co-pay.

Share this post


Link to post
Share on other sites

Does anyone have Cigna health insurance? If so do they pay anything on the surgery and fills? I'm getting ready to get all set up to see if if i'll be able to have it.

Share this post


Link to post
Share on other sites

I, also, have Medicare. My fills are at no cost to me, as what medicare doesn't pay, my insurance picks up. And, I don't pay co-pay anymore, either! Before medicre, my insurance covered all fills and offic evisists for 1st 6 months, tehn I had to pay co-pay, but fills were covered, too! Karen

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 0 replies
      1. This update has no replies.
    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×