Does your insurance cover fills?

AmberWaves · July 18, 2007

I know that my insurance will cover the procedure 100% but I don't know about the post stuff. I was just wondering if your insurance covers 100% too, do they also cover the fills?

bsimoes · July 18, 2007

I just posted the same question! I didn't read far enough down. I am due for a first fill on the 31st, and am curious to find this out. Money is really tight right now, so I'm really hoping but suspecting that it won't be covered. Let me know how you do with this. I suppose I could call the doctor's office ahead of time.

eclipse · July 19, 2007

I have gotten 2 fills so far, and UHC still hasn't picked up the cost for them, but they did however cover the procedure 100%. Makes no sense at all, the band is pretty much use less until you get the fills. Sounds to be like they need a LapBand for dummies course!

vanesav · July 21, 2007

I have Blue Cross Blue Shield Indemnity and they covered up to 1 yr. follow up including fills. I now pay $70 for a fill plus my $20 copay.

Alexandra · July 22, 2007

If your insurer covers the procedure, they absolutely should cover at least a few adjustments, or adjustments for a period of time. In paying for the surgery, they have agreed to cover the treatment for a medical condition. Without at least a few adjustments, the band is not a complete treatment and as such is not therapeutic for the condition.

If you have an adjustment declined, APPEAL. The insurance industry is still adjusting (no pun intended) its policies as the band gains in popularity, and this is an area where we all can help. Have your doctor write a letter--which he probably has written before--stating that the adjustments are a critical part of the treatment.

Bottom line: Adjustable gastric banding is not complete without adjustments, and they should absolutely be covered!

bsimoes · July 23, 2007

As always, this site rejuvenates me. I have a question and everyone chips in to answer it. Thank you all. I love the support. Barb:)

demsvmejm · July 24, 2007

Spoke to the billing clerk 7/16 about how much fills cost (my 1st 3 months were covered under the cost of surgery) I said I was wondering since BC/BS of MI doesn't cover them.......she said "yes they do"

We kinda argued back and forth for a minute and she wrote down the CPT code for me S2083 Adjustment of gastric band diameter. She said BCBS covers every time, all I pay is my $10.00 office co-pay. This code is new as of July 2007 according to my BC/BS of Michigan policy. It falls under the Obesity Surgery catagory.

bsimoes · July 25, 2007

Thank you so much; boy, I realize how lucky I was with the timing of my surgery etc. I didn't have to fight the insurance battle that so many before me did, and now perhaps I won't have to fight the fills either. At the time, it seemed to take an eternity, but now I am really grateful. Barb.

juliegeraci · July 26, 2007

Mine only covers fills with doctor on the plan. Out of network is not covered. My fills are $200 each out of pocket. Aftercare can be expensive so make sure you know for sure how much is covered. I have spent $2k this year.