Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Are Fills Coved By Insurance?



Recommended Posts

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??

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 1 reply
      1. kezbeth

        I may have to have gall bladder surgery during my weight loss surgery. Not thrilled about it either but do not want 2 recovery times. Just want it over with.

        Thanks for your post. I may need to rethink my decision... :(

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×