Pre-op testing covered?

[ravenjeh 16]

Hey guys, I have an exclusion in my insurance policy on the "treatment of exogenious obesity". So, I know it doesn't cover surgery. However, my surgeon in a different state has his out of town patients get their pre-op testing and lab work (EKG, Chest X-ray, CBC, H. Pylori...) done by their local PCP. So, I'm wondering if insurance would cover the testing. I don't think the insurance company would any idea that the stuff I am getting done will be for WLS later. Just trying to figure out how much the labs will be out of pocket since I am still saving up.

[Nancy Rivers 24]

That's my exact situation. My PCP in Michigan did the labs that my surgeon (in Ohio) wanted and insurance covered it to the extent that they cover the labs. My insurance discounted it, and the remainder counts against my deductible for the year (around $1500 before insurance - after only about $250 for the blood work alone). That's how they treat ANY labs that my PCP orders - so it wasn't specific to the WLS.

So, I don't know how helpful that was, but that was my experience.

[ChooseToChange 19]

I am in the same situation. My PCP ordered all the tests my surgeon required. As long as they code them a medically necessary your insurance should cover them. My PCP required over 3K in testing (Sleep Apnea, 2 sets of blood and urine, EKG, Echo, Chest X-Ray and 3 separate Dr visits.) Luckily my payment to the hospital covers my in hospital testing. All my post op blood work will be covered under routine blood work to monitor High BP. Good Luck!

[ravenjeh 16]

Oh, wow, thanks guys! That does help! I was really hoping that insurance would at least cover my labs like they normally would cover lab work in a non-WLS situation.

[SleeveGirl-TX 183]

My insurance covered all tests that I got my PCP to do as well

[KMP85 11]

I have had no problems all my tests were covered!