Coventry of North Carolina

ncguy3000
on 5/18/15 2:15 pm

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.

hlwillingham
on 6/2/15 6:45 am - Gaffney, SC
RNY on 02/15/16

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.

ncguy3000
on 6/2/15 6:48 am

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.

SheSingsLovelyVSG
on 10/3/15 7:09 pm

Have you received any updates from Coventry or your Surgeon? Did you have to do a 6 month supervised diet?

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