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Just talked with my insurance company...
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mousecrazy 1 post
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Wheetsin 1 post
I have a phsyical & bloodwork scheduled for Friday.
I just got off the phone with my insurance company - I was calling to determine their coverage.
The lady I spoke with told me they will cover "surgical procedures for the treatment of severe or morbid obesity" and the requirements for pre-approval include:
- Dr.'s diagnosis of morbid obesity (won't be a problem)
- Obesity history dating back at leasy 5 years (not a problem)
- Patient over the age of 21 (not a problem)
No surprise there...
I asked her what procedures, specifically, were covered and she told me I'd need a procedure code in order for her to look it up. I told her I didn't have a code, but the name of the procedure would probably be "Lapband, gastric banding, or something like that. Not gastric bypass."
She looked and then told me that "your plan doesn't exclude any particular surgical procedures for the treatment of obesity." She looked a bit longer and then said, "The closest I can find is here, where it says that laproscopic surgical gastric restriction is covered. That sounds like what you're asking about, because I think gastric bypass specifically states "bypass" in the definition. But call back when you get the code and we'll check for sure."
Then she added, "It is covered 100%."
I'm going to contact my surgical center to see if I can get a specific code, and/or see what they make of that terminology. But it sounds positive.
Sweetness!