Coventry of North Carolina
Does anyone know what the requirements that coventry has for the bariatric surgery? I have tried to talk to them and find out what I have to go through to have the surgery and they are saying that it has to be done by the doctor to find out what the requirements are. I am hoping to have the procedure done very soon since I have several medical conditions that are affected by the excess weight.
I would be interested to know if you have found out anything since you posted this. I am in SC and I too have Coventry. Since its an individual plan, I found out that they do not cover WLS unless the doctor can apply for an exception, but that I would need to meet all the requirements. Wondering what those requirements are.
I have not actually heard anything back about it, The surgeon that I am working with was telling me that coventry really did not give them much information as requirements that they have other than medical necessity. I did talk to coventry and checked my summary of benefits and it was listed as a covered service the only thing that they did not cover was weight loss programs or medications.