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Self Pay - Is this true?

Aquameliza

By Aquameliza, in Insurance & Financing

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Aquameliza    0

Aquameliza
Posted

I heard (or read or something) that if you self pay for surgery and there are any medical complications that insurance will not cover you for them (infections or other problems). That is terrifying, what if I had a heart attack or something else very expensive? Does anyone know if this is true???

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Fordgal88    7

Fordgal88
Posted

In our seminar the Dr. stated that if you were self pay and had a complication related to the surgery, the dr.s themselves would cover everything but the hospital bill. He did mention that they are trying to get a separate insurance that self payers could get just in case there were any complications.

HTH

Shawna

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Wheetsin    714

Wheetsin
Posted

Call your insuranse company and ask them if it would be covered.

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MacMadame    81

MacMadame
Posted

I talked to my insurance company about this. (Since my company excludes WLS from its coverage.) The Customer Service Rep I talked to said that if something was "medically necessary" that they would cover it. So if I was having some sort of medical emergency that required removing the lapband to treat, it would be covered.

I am not sure how much I believe this. But it did set my mind at ease a bit. I wonder if this is because they do cover the surgery if your company includes the coverage. I.E., it's not that they don't think lap-bands should be covered at all, just that my company chose to cheap out on it.

She also said that if I went through my PCP and she made a medical case for all the tests and stuff that were required to get the surgery ... i.e., that she was ordering these tests as part of treating my obesity, that they'd be covered even if the surgery wasn't.

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010308    0

010308
Posted

You've got to ask your own insurance carrier this question. Or check your benefit booklet under the exclusion section.

I have heard of some that will cover complications. But I know the company that I work for excludes any complications related to any non-covered service. WLS and cosmetic surgery are the two things that come to mind.... if you have any complication specifically related to these non-covered services then you are on your own to pay for them... and I agree, that is very scary!

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VegasGrace    1

VegasGrace
Posted

Not true.

Anything dealing with the band...of course they won't cover it...slippage, leaks, whatever.

Low potassium...YES

swallow something, gets stuck, ER for retrieval...YES

things the band can do to your body...YES...just not the band itself

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Go To Topic Listing Insurance & Financing

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
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      1. LeighaTR

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      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      · 1 reply
      1. summerseeker

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