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Old 11-01-2013, 09:21 PM
 
138 posts, read 318,927 times
Reputation: 76

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My step daughter had a childhood injury that caused a bump on her nose. The bump also caused some minor breathing difficulty. She went to a plastic surgeon in Dallas. He convinced her not to file an insurance claim, so she made the mistake of not filing. He removed the bump, but complications exist from the surgery. Another operation is needed. She is 20 but still on my work medical plan (a different policy now). Will the 2nd operation be covered by my insurance? She has went to a free consultation with several doctors and they all seem to avoid wanting to deal with her because of the risk involved. I think there is a one year limit on insurance claims, so it is too late to file a claim now for the 1st operation. I would guess the reason the doctor convinced her to avoid insurance is that he could get a higher rate for the service. Any advice?

Last edited by jackdon; 11-01-2013 at 10:39 PM..
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Old 11-03-2013, 01:42 PM
 
Location: in a house
3,574 posts, read 14,305,369 times
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Quote:
Originally Posted by jackdon View Post
My step daughter had a childhood injury that caused a bump on her nose. The bump also caused some minor breathing difficulty. She went to a plastic surgeon in Dallas. He convinced her not to file an insurance claim, so she made the mistake of not filing. He removed the bump, but complications exist from the surgery. Another operation is needed. She is 20 but still on my work medical plan (a different policy now). Will the 2nd operation be covered by my insurance? She has went to a free consultation with several doctors and they all seem to avoid wanting to deal with her because of the risk involved. I think there is a one year limit on insurance claims, so it is too late to file a claim now for the 1st operation. I would guess the reason the doctor convinced her to avoid insurance is that he could get a higher rate for the service. Any advice?
Filing or not filing insurance doesn't impact whether or not her surgery was successful. If the surgery was elective and cosmetic in nature, insurance may not have covered the procedure. As for the other, what did your insurance representative say?
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Old 11-04-2013, 05:09 PM
 
Location: Ponte Vedra Beach FL
14,617 posts, read 21,384,194 times
Reputation: 6793
The way my insurance policies always read - complications of surgery not covered by insurance (e.g., facelift) weren't covered. Complications of covered surgery (e.g., hysterectomy) were. What does the specific language in your policy say regarding this? Robyn
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Old 11-05-2013, 10:18 PM
 
138 posts, read 318,927 times
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Originally Posted by mm_mary73 View Post
Filing or not filing insurance doesn't impact whether or not her surgery was successful. If the surgery was elective and cosmetic in nature, insurance may not have covered the procedure. As for the other, what did your insurance representative say?
As I said, the bump was caused by a childhood injury, which should be covered by insurance. But my wife and kid did all this without telling me and were too stupid to file a claim.
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Old 11-07-2013, 11:39 AM
 
48,505 posts, read 96,508,741 times
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You need to check with your insurance ;policies differ. Likely they are going to want a explaination from a surgeon before giving pre approval just as they would with the original;no matter what.
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