Pre Op Appointments

[genia_deanne 2]

I have BCBSM (PPO) where I have to do 6 months of supervised weight loss and my insurance covers the surgery, but won’t cover the pre op 6 month appointments.

Anyones insurance not covered their 6 month pre op appointments? What did you do?

[James Marusek 5,244]

The worst part of bariatric surgery was dealing with my health insurance company. I noticed that they covered some of my visits to the doctor during this 6 month phase but not all. Generally it was every other visit. When I asked the insurance company why - they said medical visits for obesity were not covered. And since they had paid for some of the visits -Oh! you don't have to worry about paying us back. I said I am going to these visits primarily because my health insurance company is mandating them as a prerequisite to getting gastric bypass surgery. But that didn't seem to phase them. The whole process is totally illogical.

[genia_deanne 2]

The worst part of bariatric surgery was dealing with my health insurance company. I noticed that they covered some of my visits to the doctor during this 6 month phase but not all. Generally it was every other visit. When I asked the insurance company why - they said medical visits for obesity were not covered. And since they had paid for some of the visits -Oh! you don't have to worry about paying us back. I said I am going to these visits primarily because my health insurance company is mandating them as a prerequisite to getting gastric bypass surgery. But that didn't seem to phase them. The whole process is totally illogical.

It’s very illogical.. I think the appointments should be covered if they’re going to cover the surgery. I wish I knew how to get around this. The appointments would work towards meeting my deductible. My insurance company didn’t cover my first visit - $600 was billed to me. I wish they would’ve told me prior to the visit.

[James Marusek 5,244]

16 hours ago, genia_deanne said:

My insurance company didn’t cover my first visit - $600 was billed to me.

$600 seems a bit excessive for your first visit. My monthly visits were in the $150 range as I recall.

When you see the surgeon for the first time, you are charged for that and also when you go for the mandatory psychologist visit, that is also not covered.

But the monthly visits to the doctor who specializes in weight loss through diet and exercise is a lower costs.

[genia_deanne 2]

$600 seems a bit excessive for your first visit. My monthly visits were in the $150 range as I recall.
When you see the surgeon for the first time, you are charged for that and also when you go for the mandatory psychologist visit, that is also not covered.
But the monthly visits to the doctor who specializes in weight loss through diet and exercise is a lower costs.

Was the $150 office visits without insurance?

[James Marusek 5,244]

As I recall it cost me $150 for each visit that the insurance refused to pay.

[Apple203 1,314]

Mine were $35 each, group sessions.

[newmebithebypass 713]

Mine is $20 copay with group sessions

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[SleevieInNewJersey 53]

I just pay my co-pay for my doctor visit. I notice she usually mixes up the reasons for my visit. Sometimes it says Hypertension, sometimes it says thyroid. These are all things I do currently deal with so its not necessarily untrue.

[frust8 962]

And maybe insurance will be more willing to pay that way! Sometimes you have to beat them at their own game to succeed in this!

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