On a positive note on Insurance

Something totally amazing has happened. I had the hardest time finding a doctor to do my fills locally since I had my surgery done in Mexico. Well I finally found one and he wanted $658 for the fill. I found out that he was on my new insurance plan.( Aetna) I had United Healthcare before with a WLS exclusion. I had my surgery in Mexico as self pay on 9/14 and 9/15/2004. on 10/1/2004 my insurance swithced to Aetna who would have covered the WLS, not the band only RNY. The docs office said that no way I could get them to cover the fills since they do not even cover the surgery and on top of it all I was a international patient. (surgery outside of USA) Well they will cover my visits to the doctor for lapband adjusment. I got my primary doctor to get the preauthorization for the procedures (codes are the following in case someone needs them 99499, 43999,76000,74246) I just received the fax and I am so thrilled that they will cover my fills. All together 12 visits, amazing. I wanted to share this information with anyone else in the same predicament. All this time I believed that if you had the surgery done in Mexico, you would have a hard time getting a fill. I found someone to do them and I got insurance to cover it. Jipppiiiii. I so believe that everything happens for a reason. I strongly think I was not meant to have RNY but the lapband and this is why things worked out this way. ttfn Sari

Hi Sari~ I just popped over here from the Lap Band Forum and it was nice to see a "familiar" face! Thanks so much for the information on Aetna and the fills. I am going to Dr. Rumbaut for my lap surgery b/c the hoops I have to jump thru w/ Aetna to get the band are just not worth the headache and wait. Our plan only covers the band IF rny is not possible. Totally dumb... BUT now that you provided the codes I can check and see if the Dr. here (who will supposedly do the fills, but won't "guarentee" he will until after I have surgery, b/c he's now doing the band too--for $20,000++) Also, did you know that my tax preparer/cpa said we could claim the cost of the surgery, even if it was in Mexico, as a medical expense on our tax return if we itemize?? thanks again, and see you on the other board! Bobbi