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Port replacement and insurance

Hi All,

I went in yesterday to have my Fluid checked and see if I could get a little more added to my band. I have not had any restriction since I had an unfill in February. Well they have determined that I have a leak at my port (stem). I am wondering how difficult it is to get the insurance companies to approve this. Bariatric Surgery is covered by my insurance but it has to be preaproved. Is this considered Bariatric surgery? .....

thanks for all the input.

Robin

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Hi All,

I went in yesterday to have my Fluid checked and see if I could get a little more added to my band. I have not had any restriction since I had an unfill in February. Well they have determined that I have a leak at my port (stem). I am wondering how difficult it is to get the insurance companies to approve this. Bariatric Surgery is covered by my insurance but it has to be preaproved. Is this considered Bariatric surgery? .....

thanks for all the input.

Robin

Hi, I worked in insurance for many years and am knowledgeable of my own plan. However, I am not an expert.

My gut feeling is that they probably won't cover it since it is related to the lap band surgery but it is certainly worth a call directly to the insurance company and also to your benefits administrator.

Please post what you find out! All the best to you!

Melinda

  • Author

I did speak to my insurance company and they told me that I would need to have the Dr. call in with the code for the procedure. Lap Band surgery is covered by my insurance. They need the code so they can see if I need to have prequalification for this repair. I am hoping not since it is a repair and not the actual Lap Band surgery.

Thanks,

Robin

Hi, I worked in insurance for many years and am knowledgeable of my own plan. However, I am not an expert.

My gut feeling is that they probably won't cover it since it is related to the lap band surgery but it is certainly worth a call directly to the insurance company and also to your benefits administrator.

Please post what you find out! All the best to you!

Melinda

I did speak to my insurance company and they told me that I would need to have the Dr. call in with the code for the procedure. Lap Band surgery is covered by my insurance. They need the code so they can see if I need to have prequalification for this repair. I am hoping not since it is a repair and not the actual Lap Band surgery.

Thanks,

Robin

I am sorry, I misunderstood you, and didn't realize that the lap band was covered by your ins. That being the case, I would really be surprised if the repair isn't covered. I would think that all the doctor would have to prove is the medical necessity for it. Let me know. You have my curiousity going. All the best to you,

Melinda

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