will complications be covered?

[lunarose 97]

Hi All, I have Kaiser but do not qualify for the surgery through them my BMI is 36 they want 40 or 0ver unless you have diabetes which I don't so I will be self paying here in the states. My question is if I were to develop complications would I be able to have them treated through Kaiser or would it also end up being self pay? Also would I be able to apply the costs of the surgery to my deductible?

Thanks Nancy

[mmcclure 3]

I also asked this question when I started out researching the various ways and means to get VSG. I even called the insurance company. They told me that, no, if the surgery is not covered then any complication would not be either.

On the other hand - it is my impression that, after time has gone by, it would be very difficult for the insurance company to differentiate between a complication from WLS and something else. So, there is a chance that if a complication were to arise farther out from surgery, it would probably be covered.

One thing I am doing is getting a referral from my PCP to my surgeon for hiatal hernia surgery. At least that part will be covered if he finds one and fixes it while he is doing the sleeve. And, God forbid a complication arises - maybe it would be caused by that and not the WLS. :thumbup1:

[mila1013 0]

Hi All, I have Kaiser but do not qualify for the surgery through them my BMI is 36 they want 40 or 0ver unless you have diabetes which I don't so I will be self paying here in the states. My question is if I were to develop complications would I be able to have them treated through Kaiser or would it also end up being self pay? Also would I be able to apply the costs of the surgery to my deductible?

Thanks Nancy

Nancy every insurance policy is different so it is difficult to answer this. Medical emergencies should be covered on all policies. the complication you should worry about is leaks that can be devastating on the body and financially, again read your contract for specific language. of course the cost of surgery can not be applied to your deductible it is denied and hence not covered, only covered services can be put to the deductible, but you can write it off on your IRS taxes....