Question:
Does insurance cover post-op stuff?

I was wondering whether insurance covers complications and/or follow-up labs, etc. I was thinking that I could just change insurance providers during open-enrollment...then the worst thing would be a pre-existing conditions clause. what do you guys think?    — Pamela B. (posted on January 16, 2002)

January 16, 2002
If you are going directly from one insurance to another, especially via an employer, with less than 30 days gap in coverage there should be no preexisting condition clause. During an open enrollement, your coverage should be seemless so you shouldn't have an issue. I'd check the literature, but that is normally the case.
   — Tina P.

January 16, 2002
Seems most people say their insurance covers post op labs, as mine does, too. However, you need to be sure your doctor uses a "correct" code when he orders the follow up labs. For my first lab tests my doctor used a code that basically said it was to "rule out" any deficiencies (it was a "V" code) & my ins denied the claim. The Dr revised the code to one having to do with malabsorption due to surgery & my ins now pays them without fuss. This is important, too, as those post op labs coast around $200 each & I had them every three months for the first about 15 months & now have them every six months. It sure does add up. I never had post op complications, but if you had any medical problems I'm sure your insurance would cover them...especially if they approved & paid for your surgery.
   — Kathy W.

January 16, 2002
Tina is correct! If you change insurance during open enrollment,and have not had a lapse in coverage for more than 30 days, you won't have a pre-existing clause. It is against the law.
   — Karen B.

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