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Are Fills Coved By Insurance?



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I have Empire BCBS and got approved for surgery but not sure about fills? What the normal policy on this if you insurance does cover the surgery??

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I have BCBS-IL, which I think would be similar and I went round and round with them before I finally got an answer to that question. The answer was that the surgery was approved as medically necessary, therefore any and all "maintenance" required would also be covered.

My surgeon covered 2 months, but the third month got submitted to insurance, and never got processed. My surgeon billed $650 for the fill, and I flipped out at the thought of having to pay that monthly. It turned out it was a "glitch" in the BCBS system, and it ignored claims from my surgeon. My surgeon was fine with waiting - but I was freaking out! I've got my next fill on Tuesday, and I had to demand an answer before I go, cause I can't afford it otherwise. Once it finally got reviewed, they only allowed $410 - but that's still not something I could absorb monthly!

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I have anthem BCBS, and when I called to ask about my bariatric benefits, they sent me a statement which also said fills are covered. I am guessing the fills are at the 20% policy, unless you've already paid your max out of pocket for the year.

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I have BCBS Fed. My surgeron said everything from 3 months after surgery is included in the surgery insurance claim. He said after that I would just be responsible for my co-pay ($25) per visit.

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I have Medicare and they covered the first year of fills. Now I have to pay for them ($160) each. I only go in about once every 6 mths now, so it's not too bad.

Marci

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wow! I didn't realize the fills were that much money!!!!

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BCBS CA Access+ H M O here, after the first year, I just need prior approval for fills and visits to my surgeon. Other wise, I am covered. Approvals take about a week.

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I have to say that I LOVE my insurance, they cover my fills with just my $20 co-pay.

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Does anyone have Cigna health insurance? If so do they pay anything on the surgery and fills? I'm getting ready to get all set up to see if if i'll be able to have it.

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I, also, have Medicare. My fills are at no cost to me, as what medicare doesn't pay, my insurance picks up. And, I don't pay co-pay anymore, either! Before medicre, my insurance covered all fills and offic evisists for 1st 6 months, tehn I had to pay co-pay, but fills were covered, too! Karen

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