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What does this mean?

post-293524-14653528651437_thumb.jpg

So here is my benefits under bariatric, but what does 90 days before or after surgery mean?? How do you all read this?

Do I have to see specialist prior to scheduling surgery or can I do that after the surgery? So confused

Thanks

Jen

Sent from my iPhone using the BariatricPal App

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  • Sharon1964
    Sharon1964

    It means that surgery at a Center of Excellence is a package deal, completely covered (looks like no copay). So any visits you need for 90 days before or after are part of the package. Looks like so

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It sounds like any appointments you have 90 days before and 90 days after surgery are covered if they are at a Center of Excellence. If in doubt, you can always call and ask for clarification.

It means that surgery at a Center of Excellence is a package deal, completely covered (looks like no copay). So any visits you need for 90 days before or after are part of the package. Looks like some awesome insurance coverage.

It's like when you're pregnant, your insurance doesn't pay for every individual visit with your obgyn, they pay one price for a package of care that includes normal prenatal visits, normal delivery, and 6 weeks aftercare.

@@Jenjen2016 -- But when choosing your surgeon/hospital be careful -- if you do not use a center of excellence or if you go out of network it appears you have no coverage at all. Once you pick a doc, call the insurance company to confirm s/he is in network and at a COE they approve.

I take it to say you must follow up with the surgeon etc... After the procedure... My surgeon said he has people who get the surgery and never come back for follow up care....

Request for approval would be submitting with 90 days of meeting with a surgeon.

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

Edited by nyteacher125

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