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Insurance Won't Cover Hernia, Why?

I was recently banded on May 30 and also had a hiatal hernia corrected. I was a self pay for my band but now am finding out my insurance won't even pay for the hernia. Anyone else experience this or know why this is? I understand not paying for the band but not the hernia.

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  • I am assuming it is because it wasn't pre-approved? The hernia fix wasn't included with your band surgery?

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Appeal their decision.

I am assuming it is because it wasn't pre-approved? The hernia fix wasn't included with your band surgery?

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No apparantly it was not included in the cost of the band, which I did not realize until I got the bill.

Definitely appeal, perhaps get the surgeon's office to help you. A hernia is a medical issue and is always insurance approved.

It could even be something as simple as a coding issue, or the surgeon needs to submit the bill for the band and the hernia separately.

I would appeal too. That really sucks! I actually just had a hernia repair done on Monday... and my insurance also covered my band being re-positioned even though bariatrics are not covered by my employer! Definitely fight it. Hernia should be covered... for sure! Good luck.

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