Question:
Is there a limit to the period of time complications won't be covered?

I will be self-pay because my insurance has an exclusion (BCBS PPS). The exclusion states that there is not benefit for the surgery and any related complications. Does anyone know if there is a limit of time at which point a complication would not be considered part of the surgery. If I had adhesions or a hernia 1 year after surgery, would that be considered a complication?    — Carol P. (posted on March 9, 2003)

March 9, 2003
This is a good question. I'm just sorry I don't have an answer to it because I'm wondering the same thing. I too am self-pay; however, I'm hoping that something such as a hernia would be covered because I don't know that anyone can actually prove that it came from surgery. I was told I could probably have a hernia right now and not even realize it because of my weight. I have kaier Perm. which is a closed HMO and I don't think they can not treat me for life threatening conditions. I hope not. Anyway, I plan on submitting everything for approval and appealing anything that gets denied. I think I asked this same question a while ago and the answers were varied based on insurance. I guess I'll take my chances!! Good luck! Denise (Pre-op scheduled 3/20/03)
   — denisel