hollywrites2u

Congratulations! Enjoy reaching your well deserved goal! I remember that well! I was also so excited that I was able to start wearing an XL rather than plus size clothes when I got down to 195.

Hello all, has anyone had any luck with getting their secondary insurance to pay for their surgery when the primary doesn't cover it? My employer provided healthcare insurance is Florida Blue & it sucks. There's an exclusion for everything related to bariatric surgery - no band, balloon, gastric bypass, sleeve, revision, or repair of previous surgeries. My secondary insurance, BCBS Michigan, covers everything. It's a great plan and I hardly had to pay for anything when I got the lapband 20 years ago. I've had trouble with the band & I want to get it removed. I would like to get a revision to a gastric bypass so I don't regain all the weight I lost. I've made some calls to surgeons & was told by one insurance coordinator that if my primary rejects paying for it then my secondary won't pay for it because that's "coordination of benefit". Arrrghh I'm going to see a surgeon in a couple weeks. I haven't seen a bariatric doctor in 10 years (my bad). [emoji44][emoji38] I had talked myself out of the fear of getting a revision to a bypass & now it seems that I can't get it. I'm so mad at my employer for providing minimal, crappy insurance & that having secondary insurance doesn't help at all. Background: I'm 5'5 & 240 now. I was 5'6 & 315 in 2002 when I got the band. I got down to 195 but had saline removed 10 years ago after having some problems. Now I have GERD & some other issues.

Congratulations on your revision! That's awesome that the surgery went so well and you are managing the pain well. I want to get my lap band removed & get the gastric bypass at the same time. The surgeon's office that I called said the doctor only does one surgery at a time. I'd have to wait to get the band removed and wait for three months before he would do the gastric bypass. I don't want to go through two surgeries and my insurance will only pay for one surgery "per lifetime". If you don't mind sharing, what did your surgeon charge for the two procedures? I've read it can cost around 10-12k to remove the band and 20-25k for a gastric bypass. I'm sure it has to be cheaper to do both at the same time then do the two operations separately. Thanks for any info you can provide! Holly

That's a good idea! Thanks for the suggestion. My insurance should cover a repair that isn't actually bariatric surgery. I wonder if the surgeon could do a bypass and my secondary would pick it up when my primary doesn't. I'll have to research more about it. I have an appt. with a surgeon in a couple weeks. Who is your surgeon?

I didn't know about complication insurance either. That's great!

WhispersOfAngel I thought about Mexico today if my insurance won't pay. I read some horror stories on here so that's not going to be an option. I'd never thought about doctors here not accepting someone as a patient or insurance covering it. I

Florida sucks! That's good to know liveaboard15. I wish I'd read your post before I wrote to Human Resources. lol I definitely can't afford to do self-pay at this point in my life. I'm going to see the doctor to try and make sure everything is okay with the band. I'll make sure to check that the insurance will cover a consult. The office told me that they won't pay for fills and they cost $150. That makes sense with what you've told me that they won't cover anything. I've heard that a hiatal hernia and problems with the esophagus can happen because of the band. I would hope that insurance would cover that!

Thank you for the feedback! Who is your surgeon? I had my original surgery in Tennessee. I moved to Florida about three years ago. My former surgeon was awesome. Great job and very caring. He passed away several years ago or I'd consider going back to him if my insurance covered it.

Hello all, I am having trouble with my band and want to get it removed. I have acid reflux constantly and I'm worried it's ruining my esophagus. I always feel like I have a lump in my throat. I was advised to remove the band and get a gastric bypass in its place so I don't gain all the weight back that I've lost and will continue to lose weight. My presurgery weight was 315 lbs. I got down to 195 over a five-year period but I had some issues. I had a slippage a couple of years after I got it and had to get it repaired. I had an incident where I couldn't get anything down (even water) so they removed all of the fluid. I was afraid to get it filled again. I've gained back quite a lot of weight. I weigh 243 lbs now. I'm 5-6" so I'd like to get down to around 150-160 lbs. My primary insurance, Florida Blue, excludes all bariatric surgery. ? I have great secondary insurance, BCBS Michigan, that covered my original band surgery (at almost 100%). I had the office coordinator at one of the doctor's offices that I called about a consultation tell me that my secondary won't cover anything if my primary doesn't cover it because they only pick up costs after a claim is filed. This "coordination of benefits" is pretty crappy for the consumer. I'd love feedback, especially from anyone who had health insurance issues like this or had a revision surgery to a gastric bypass. Was the band removal surgery and gastric bypass done at the same time or did you have two surgeries? I'd like to get it all done at the same time rather than have two but I've read that some doctors will only do the two procedures separately. Lastly, I've also read that the band's "shelf-life" is around ten years due to possible erosion issues. When I originally got it, 20 years ago, I was told that it was for life but could be removed if there were any problems down the road. Sorry this is so long. ? Take care, Holly

You are amazing! Thank you so much for posting this! Really gives me hope I can do it again. I was banded by Dr. Morton five years ago and lost 110 lbs. I got off track and gained 15 back when I needed to lose another 50. : ( I am getting a fill from him this month. The first one in years. I feel badly that I've not appreciated the band as it really did change my outlook and how I feel so much. Your weight loss is an inspiration to me! Thank you, Holly

Hi! I was banded by Dr. Morton. He's fabulous. It's natural to be nervous, but it will be fine really. I had my band done five years ago and lost 110 lbs. but then I slacked off and regained 15. I'm getting the first fill I've had in years in Feb. I feel badly that I've not appreciated the band as it really did change my outlook and how I feel so much. You'll do great! Looking forward to hearing more about your journey. Holly

Hi! I was banded about five years ago by Dr. Charles Morton. (WONDERFUL doctor!) I started out and my BMI was 50. I set my goal to lose 150 lbs. to be at a weight I thought I could be healthy and happy with. Over three years I lost 110 lbs, but I got slack with my program (I'm embaressed truly) and stalled out. I have regained 15 lbs. of what I initially lost. The band really did change my life and give me so much of my health back and I have really taken that for granted. I am going to get a fill (first one in years) for Dr. Morton on 2/19. I would appreciate any feeback and advice anyone has to give. Thank you, Holly