I'm paying out of pocket. If I have a complication down the road, will ins cover?

[Happy_Girl 0]

I'm paying cash for my lap band in January 2009. If I have a complication at some point in the future that requires additional procedures (i.e. slippage, erosion, etc.), will insurance cover those costs?

[alegna242 1]

I'm going to be a self payer myself. It's been so long since I've had insurance I cannot tell you for sure. The thought of future complications is something that I am terrified of and one of the reasons (beside finances) that is keeping me on the fence about doing this. From what I gather I highly doubt it, if they don't pay for it in the first place then they won't cover anything after. I'm sorry I don't have an answer but I feel the same as you, someone on here will have some insight.

[MacMadame 81]

I looked into this once I found out that my company had an exclusion for WLS.

What I was told by my insurance company is that if I have a complication that involves removing the band, that they will not pay for it. However, other complications such as for blood clots would most likely be paid for. But there are no guarantees.

You need to talk to your insurance company though because it will depend on their policies and the exact wording of the policy.

I found mine was pretty good about paying for everything I submitted -- which was all the pre-op testing, the post-op prescriptions and even my stomach biopsy -- which was a direct result of my surgery and so should not have been covered.