Originally Posted by
Batmanswideisloosing
I am not positive but I believe with WLS it depends on if insurance paid for it, what I mean by that is if your insurance does cover it and you self pay as to not go through psychiatric classes and nutrition counseling and such all to avoid waiting then I am pretty sure they will NOT cover the "complication" should one arise because they did not approve the surgery and you did not follow their rules etc.
Now if they cover it and you go through their steps and they decide that you are mentally, and physically ready and educated enough and they pay for the surgery, then after that I am 99% sure they cover the complication if it arises.
If insurance does not cover WLS and you self pay and there is a complication that the doctor deems is DIRECTLY related to the surgery then almost always they will not cover it. However if it was something where you went to the ER and don't specifically write down that this problem is for sure related to this surgery then it can slip through.
I self paid in Mexico and had the issue that my incisions opened after I removed the stitches (probably should have left a few more days but was impatient) I went to the urgent care in town, they saw me, and just wrote it up as an opened wound but made no mention of my WLS so my insurance covered it. However I went to my PCP to get a yearly check up and run blood work to check all the cholesterol, vitamin etc etc stuff and she wrote down that it was a blood check for post WLS care and my insurance denied my claim to pay for the blood work and office visit. My PCP physician and I have since talked about that and it was resubmitted and paid, because I was in fact there for my regular every year once a year routine stuff. I was not having issues, was not concerned about any levels or anything like that. I would have had the same testing whether or not I had the surgery. so just keep that in mind.
Also ask your insurance if you were to self pay if there could be any reimbursement later as I have seen and heard of it happening sometimes.
Good luck to you
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