Are We Covered?

Dear Sisters,

Someone raised the insurance issue with me yesterday and frankly, I hadn't given it a thought. How are you sure your policy will cover the surgery? Is it ever considered elective when a doctors recommends it? I'm a little leary of asking my insurance carrier since I don't want to start something. Is the doctor the one to ask?

Thanks,

Kate

I think it's a good idea to call your insurance company. I found out that I would save a fortune by having mine done before the end of the year.

If you have an employee handbook it might be in there.

It's not like it's elective surgery. One of my friends added on a tummy tuck and they even paid for that because it was called reconstruction.

Ya never know. Good Luck.
dlr

Kate - When my gyn. suggested hyst...and I said OK...the nurse called and got it approved before I left the office. I didn't have to call my insurance co. at all. Matter of fact, I only talked with them once - it was the staff insurance nurse - and she asked me if I had any questions and gave me this website. I sure am thankful for her!!!!!

Hi Kate,

This is Dawn in Mpls. I called my HMO when I decided to go ahead with the hyst. Although, it is considered elective surgery to the HMO, it was 100% covered. I just called customer service and they didn't even ask my name....just my plan.

I guess I would want to know before I went in! Good Luck!

The surgery coordinator at my doctor's office submits all the paperwork and calls for the approvals to the insurance company. I've never had to call them for pre-approval, the Doc's office does all that. You may want to check with your doctor's office staff.

BSQ

The surgery scheduler usually calls the insurance to see if the surgery needs to be precertified, but precertification and coverage of the whole thing are two different matters. I would check your plan because they are all very different. If you have insurance through you or your husband's company they have provided you with a book that should have all of this info in it. If you have a plan that covers it, of course, you have to have a medical reason to have the hyst (which I'm sure you do) and the Dr's office has to give the diagnosis and proper ICD codes. I worked in a medical office.

Hope this helps.

Sherry

Dear Sisters,

Thanks! Great advice, as usual.


Kate