Insurance Won't Cover Hernia, Why?

[gman614 2]

I was recently banded on May 30 and also had a hiatal hernia corrected. I was a self pay for my band but now am finding out my insurance won't even pay for the hernia. Anyone else experience this or know why this is? I understand not paying for the band but not the hernia.

[Wtloss 75]

Appeal their decision.

[adorkbl 156]

I am assuming it is because it wasn't pre-approved? The hernia fix wasn't included with your band surgery?

[gman614 2]

No apparantly it was not included in the cost of the band, which I did not realize until I got the bill.

[Terri jg 2]

I would appeal, mine didn't cover the band but they did the hernia repair

[DELETE THIS ACCOUNT! 12,703]

Definitely appeal, perhaps get the surgeon's office to help you. A hernia is a medical issue and is always insurance approved.

It could even be something as simple as a coding issue, or the surgeon needs to submit the bill for the band and the hernia separately.

[adorkbl 156]

I would appeal too. That really sucks! I actually just had a hernia repair done on Monday... and my insurance also covered my band being re-positioned even though bariatrics are not covered by my employer! Definitely fight it. Hernia should be covered... for sure! Good luck.