ins

Has anyone had med. mut. for their lap band? If so did they pay or deny?

My husband and I both have Med Mut policies and both specifically exclude WLS...it really depends on the ins. co's contract with your employer.

Thank you for your reply. My policy does cover this but even though I do meet the qualifications I have still been denied. I am waiting now to see what comes out of appeals. I hate waiting it is so frustrating not knowing. Jones

Like the poster before it all depends on what your company has contracted with MM and how your policy is written.  I had MM back in 2003 when I had open RNY. My policy covered everything just like any other surgery as long as I met all the requirements. They covered both RNY or BPD-DS but not the BAND.  Again that was back in 2003. A lot can and has changed since then.  Our current policy now only pays a max of $10,000. for any WLS after you met all the requitements. Your best bet is to call MM and find out what YOUR policy states.  Good Luck,  Robin

Thank you for yout reply. MM does  cover this but the are still dening me even though I do meet requirements. I guess now I am playing the waiting game. In appeals. Thank you again, Jones

I have Med Mutual, they pay for RNY & Band. I appealed twice and was finally approved after asking for an outside review - however, they are very particular about the documentation they want. So while I was waiting for appeals, I started going to my doctor monthly to make sure I had the records they wanted.

Oh man, I hope I do not have to go through all that It is so frustraiting. Thank you sharon your comments do help so much. I do not feel alone being able to contact others. Thank you sooooooooooooo much

Glad I could help. And make sure you get a copy of the denial so you know exactly what they need.

Sharon got an update when I got home. Med. Mut. denied again and said I need to have all these other life threatening things in order for them to approve but if I HAD ANY OF THESE i WOULD NOT BE ABLE TO HAVE THE SURGERY. but my other ins. said that they would pay for it 100% Buy Buy Med. Mut. Thank you Sharon

I'm glad you have another insurance. I unfortunately had Sleep Apnea, asthma, and arthritis on my side.