Lapband Fill And Ins Company

[Grider 92]

Just got my bill from Dr from when he started doing the fills, 3 months ago. He is charging me $500 to put in the saline without any xray or anything and the Ins is not paying ziltch but they lower it to $111.... so I called FEPBLUE and starting a conversation about whose is responsible for what,,, as I am already trying to get the Hospital to take lower payments, for my $1100 I owed them after the surgery. I am more than dead broke and have cancelled cable etc etc. to pay for this unexpected fees and co- pays. Wondering how your insurance co's are handling this aspect of it. I told her you take my blood and make tests that run $1000 and pay for it but not pay for a shot of saline? makes no sence anyone?

[Jim1967 3,569]

I have not yet had a fill. My first is scheduled next Tuesday. According to my insurance they cover it but I just don't know how much I will be responsible for. Typically my company pays 90%.

This is in the Cigna policy:

CIGNA covers adjustment of a silicone gastric banding as medically necessary to control the rate of weight loss and/or treat symptoms secondary to gastric restriction following a medically necessary adjustable silicone gastric banding procedure.

Makes zero sense they would cover the surgery and not cover routine fills. I would definitely appeal the highest authority if I were you. Ridiculous....

[Mayasgram 351]

My Dr gave me the first 6 monthes of fills included in my surgery cost. My insurance then paid 80.00 of my 100.00 fill. THe Drs cost sound really high. I only needed a scope once in 3 years and that was fully covered.

[SageTracey 608]

Fills are fully covered by the Australian healthcare system!

[JessiG1983 50]

My insurance covers my fills. I only have to pay my $35 copay. I have had no issues there...sorry you're going through this!!

[Grider 92]

Any of my FEPBLUE comparts out there?

[DeAna N 229]

I thought that you pay your portion of the bill up front. If you do have to it should make you meet your out of pocket expense, right? so I shouldn't have to pay co-pays after that right? not sure that I understand how it works.

my total out of pocket expense right now is $2381.00 but my deductible is $650.00 my plan is a 80/20 plan so do I just have to pay the $650 before surgery and they bill me the rest? I thought I had to pay the 2381.00 when surgery is scheduled.

[Grider 92]

I have been billed for everything excpet co-pay/ My thing is- that nothing is in writing ahead of time. what I mean is- that you have no idea how much you are expected to pay for what. A freind of mine say her fills are included with surgery- everyone pays different because of different surgeons and hospitals, so you can't really know ahead of time. They do not give you a fee schedule to prepare. Anyhow, calling the ins co back and see what can be done for them to pay some of the fills.

[DeAna N 229]

well tha kinda of sicks I was think once I paid the balance to the hospital I would not have anymore out of pocket expenses for the rest of the year. Sorry you are having so much trouble.

[Grider 92]

Just talked with insurance company- apparently a " FILL" is coded as a surgical procedure, therefor they can bill whatever they fill their time is worth-- (golden saline ?) so my co-pay for any surgery is $150 so $111.00 is my part... I guess I am on my own as I cannot afford $111 a fill- already owing them $300+ for the last 3 fills. until I at least pay what's left of my hospital bill from this surgery. well folks,, this too shall pass....

[Jess55 97]

I'm surprised that people didn't know what the fills would cost. My surgeon told me like at my first consult I'd be paying $100 per fill. Now I didn't realize with the one and only one I've had it was on top of my $50 copay, but whatever.