Insurance question

[Bschucher 0]

Hiya folks.. I have a question perhaps someone can answer. Im going to be self pay for the band. Assuming a negative for a second and i need any procedures for a complication like slippage or someting else that would require them to "go back in", would my health insurance typically pay for such a procedure?

[princess_n_thep 2]

Some do, some don't. Mine will pay for any complications such as erosion, but then again, my original doctor does it for free. But then I would have to go back to Mexico. I would be torn with the idea and would have to seriously weigh the pros and cons. (and I would take Lisa with me if I went to Mexico because I know she would never let anything bad happen to me)

I have heard that some insurances will pay for gastric bypass conversion if something happens with the band. While they are in there, they convert you. This is probably what I would do I think if I had to lose the band.

Some insurances have an exclusion clause and won't pay for fills, some do pay for them after. I haven't even checked on mine for that one.

I think it depends on what insurance carrier and what state you live in. Post your insurance carrier and state and see what kind of responses you get.

[Alexandra 55]

Bschucher, typically insurance carriers have to pay for medically necessary care. If you have a band implanted and something happens to it later on, the care involved would be considered medically necessary and therefore be covered. It doesn't matter if your carrier paid for the initial surgery or not; if the complication is far enough out from surgery that it isn't part of the same procedure -- that is, after you've healed -- it should be covered as a new medical situation.

But do check with your carrier to be sure, since laws vary from state to state. Look through your plan document to find the list of exclusions. Good luck!!