Does insurance approval still apply if I change providers before my surgery date? (Photo)

Question

My breast reduction surgery is approved, but my insurance is scheduled for January 2016. The problem is that my company is changing to a different insurance provider starting January 5. Do I hurriedly find another reputed plastic surgeon to perform the surgery this year or would the approval still apply should I change companies in January? I met my deductible for this year - 2015.

Sheila S. Nazarian, MD · Answer

I am not an insurance expert, but I am fairly certain that your current insurance will not apply after 1/1/16. I would suggest that you contact your surgeon's office, explain the situation and see if they can fit you in before the new year. Best, Dr. Nazarian

Rukmini S. Rednam, MD, FACS · Answer

Hello,I'm sorry to hear you are in this situation but unfortunately if your company is switching insurance providers than you will have to go through the pre approval process again if that particular company requires precertification.  If you have some flexibility with your schedule, I would talk with your plastic surgeon's office and see if they can move your surgery date up before the switch. Most offices will try and work with you to help you in this type of situation.Best of Luck!Dr. Rednam

Joseph M. Perlman, MD · Answer

insurance plans very in regards to whether they cover breast reduction surgery or not. After reviewing your present plan and the benefits from the new plan that takes place in January, you'll have a better knowledge of what is the best course. If you wait until the new plan takes effect, you'll have to reapply after your waiting. The doctor your presently seeing may not be in the new plan so you have to get consultation with a new surgeon. All these variables have to be considered. Good luck to you

Wesley T. Myers, MD · Answer

Thank you for your question. Any change in insurance would require re-authorization of the surgical procedure.

Ronald V. DeMars, MD (Retired) · Answer

After January 1st you will no longer be covered by the company that gave you preapproval. If you explain this to your surgeon I bet the office will find a way to work you into the schedule before the end of the year. If you do not want the surgery that soon you will need to go through the preapproval process all over again and there is a chance the new company may not approve you.

Does insurance approval still apply if I change providers before my surgery date? (Photo)

Answers (5)

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