Self pay for surgery but Insurance covered fills?

[vkcse03 0]

Question: Even though you paid for the surgery out of pocket did your insurance then pay for all your fill appointment?

I'm wondering if I can appeal my insurance rejections by writting them a letter of the cost of the fills verses what they would have to pay for my medical health care if I DID NOT have the lapband surgery. Has anyone appealed and won?

[jmegirl 2]

I'm pretty sure I read somewhere that most insurances won't cover fills if they didn't cover the band, but I'm sure this depends on each person's insurance. My insurance won't cover the band without a long list of requirements being met - none of which I really care to do - so I'm a self-pay going to Dr. K in CO.

[silvers320 12]

I appealed and won. It added an extra 30 or 45 days to the process but I saved $12,000. In my state, you can appeal the state department of insurance - which is what I did. Well worth the effort

[jazie 0]

I just called my insurance to see what the procedure was for the fills. My dr says most insurance don't cover fills, but mine covered the surgery and will pay 80% on the fills which are $125. I am very happy with that. With the new year comes deductibles again, but I will sell something if I have to. I am determined for this to work

Jazie