Post Ops - Aftercare with PCP

My insurance will not cover my surgery - that I know. I was just wondering if they will cover my visits to my PCP. I'm sure my PCP will want to check my blood work more often to make sure that everything is okay. Has anyone run into any issues with BCBS or any other insurance not covering anything related to the surgery? What if I get a stricture - will insurance cover that expense? I don't want to call them and ask because it might be better that they not know I'm having the surgery that they consider "not medically necessary" (whatever!), if you know what I mean. This surgery is putting a strain on my budget - but is well worth it in my opinion. I just need to know what to expect after the surgery. Thanks! Surgery scheduled with Dr. A - 2/18/05!

Hi Kris. I have BCBS also. They will not cover ANYTHING to do w/WLS or problems afterwards. I'm thinking I may have a cold, sore muscles, etc. when I need to see my PCP. -

hi there, My insurance would not cover the surgery either. But I am doing my post op appts with a doctor in Tacoma washington and Im going to have them bill it like a regular doctor visit. I think there are ways for them to sneak that in without calling attention to it. For the blood work the doc just needs to put a different code that your low on something so he is checking your blood count. It shouldn't be too hard if your doc is willing to cooperate. Are you in Washington state?? Cindy Federal way Surgery in 1 week.. YIPPEEEE

Hi Kris! I have BCBS and had to be self pay for my surgery. I have seen my PCP several times and had blood work at most of those visits. Each time I go I discuss my sleep apnea, arthritis, headaches, etc. anything that will make it a visit for one of those instead of obesity. BCBS has paid all my visits, it's all in the coding. In addition, I'm seeing a baratric surgeon that has accepted me as a follow up patient. They coded my visit malabsorption and BCBS paid it, too. I can't answer your question about a stricture or anything like that as I don't know if they would pay or not. I just assume they wouldn't. The President of the company that administers our insurance benefits programs insists that BCBS would have to cover any problems now that I've had the surgery. He works with them all the time so I guess he would know. I'm just not counting on it. Cheri

I have BCBS and have not had a problem with follow up visits. I just make sure they don't list that it is obesity related and there are no issues. I had my staples out, all my labwork done and never had an issue so far. I don't know that they would pay if I had to be opened back up for something or had a stricture, but at least the routine stuff I've not had a problem with. Dina