Will insurance cover complications/ repairs?

ShawnaC · February 10, 2008

Last year I got my band with United Health Care PPO. They covered the band without any problems. This year I'm still with United Health Care, but have the EPO and this plan does not cover WLS.

I'd like to know if the EPO will cover a follow up surgery for complications such as repositioning for a slip or removal for erosion. My instinct tells me that they will cover it if it's considered life threatening.

If you have been in a similar situation or have an opinion, I would love to hear it.

Thank you

gordonfamily3 · February 13, 2008

I work in the insurance for my surgeon and this situation would be hard to answer. My exp is that is their isn't WLS coverage they will pay to have it removed but not to repair it. However that has just be my exp w/ the insurance companies that I have dealt with. UHC being one of them. Sorry I know that wasn't the news you were looking for but wanted to share what I had exp with. Now also if you are denied you could appeal and they could always approve it. So who knows with insureance companies.

Now I have seen most of them cover the fills becuase right now there is no CPT code for the actual fills right now. I am sure they are to come soon.

Let's have positive thoughts....that nothing will happen to you.

ShawnaC · February 13, 2008

Thanks for the info, Kim. I was unfilled on Monday b/c my band had the beginnings of a slip. Neither the doctor nor I want to have another surgery to reposition it, so we're hoping it will settle back down during this unfilled time (3 weeks).

Thanks again for the info :mad: