Did You Insurance Pay For Band To Sleeve Revision?

[Gigi_Girl 77]

I had my lapband in 2008. My band has a leak. They sent the paperwork to my insurance ( Optima ) and they gave their approval within 2 weeks for me to have the band to sleeve revision. They pay for all of it.

My surgery is May 3

I hope I know in two weeks! The insurance company got my doc's paperwork on May 1.

Hope your surgery went well. Keep us posted!

[Gigi_Girl 77]

I had my band in 08, lost 120 .sooooo happy then I became pregnant with twins after the told us we couldn't become pregnant on our own.had a great pregnancy gained 40pounds. Delivered 7 pound babies.then it slipped and I had it lossened more in more even with nothing in my band I threw up.uk had my recession on April 24, after 5months of jumping threw hoops and I started at 290 surgery day now I'm 258

Wow! what an ordeal. Hope you are doing well post-surgery. Keep us posted!

[Wheetsin 714]

Do they list those things specifically? Generally those are considered what's called "mechanical failure" of the band, and a leak would definitely be a mechanical failure.

My BCBS is CA/Anthem, but overall BCBS seems rather WLS friendly. Hopefully you will receive good news.

Unless you really want to, don't wait a week. Between calls I waited about 3 days max, when it included a weekend.

_{Wheetsin, thanks for your history. My provider is BCBS of AL. They say revision are possible for infection of port or erosion or slippage of band. Nothing is said about leaks. I was told it is a case by case basis. I checked again today and still no answer. I'll wait another week before I call back. Thanks again for your support.}

_Gigi

[PEvette 297]

My insurance denied RNY and Lapband back in 2005, so I self-paid for lapband....now 7 years later, after changing districts, my new school district has a exclusion for any WLS, so I have to self-pay for my revision...

[Wheetsin 714]

One of these days there's going to be a class action suit filed against Allergan & Inamed, I can just feel it.

[iwannabslim 67]

I have BCBS of Illinois, and they approved my revision last week. I don't have a slip or eroision. I just wasn't getting good restriction AND started regaining weight over the last year. Aslo, like Wheetsin said, call the insurance company. I started calling the day after my paperwork was submitted. I'm sure they are used to patients calling to question the status all of the time.

[Gigi_Girl 77]

My insurance denied RNY and Lapband back in 2005, so I self-paid for lapband....now 7 years later, after changing districts, my new school district has a exclusion for any WLS, so I have to self-pay for my revision...

I congratulate you on being able to get til your revision. Sorry about your luck with your carrier(s).

My insurance had only begun paying for lap bands a year or two before I got mine. Now it has been only a year or two since they approved the sleeve. The question lies with how strick they are for revisions with mechanical failure. Seems like a no brainer. We see.

[Gigi_Girl 77]

I have BCBS of Illinois, and they approved my revision last week. I don't have a slip or eroision. I just wasn't getting good restriction AND started regaining weight over the last year. Aslo, like Wheetsin said, call the insurance company. I started calling the day after my paperwork was submitted. I'm sure they are used to patients calling to question the status all of the time.

Thanks for the support iwannabslim. Congrats on your approval. How long did it take the medical review board to approve your revision?

[Gigi_Girl 77]

One of these days there's going to be a class action suit filed against Allergan & Inamed, I can just feel it.

Amen!!!

And yes, they listed those items specially.

[iwannabslim 67]

Thanks for the support iwannabslim. Congrats on your approval. How long did it take the medical review board to approve your revision?

Once they had all of the information that they wanted, it only took a couple of days. My biggest wait time came because my band doctor's office didn't send all of the information that insurance wanted. After they submitted, insurance requested documentation that I had been following the doctor's eating and exercise plan.

[FXDF2008 14]

I also have BCBS-AL and had my band removed due erosion on March 29th. Had my band placed 2/7/2008. Waiting now for my surgeon's office to file the claim for revision to sleeve. I haven't been real happy with them as of late and if I don't hear that they have filed my paperwork by the end of next week I am considering switching surgeons. Not happy with having to tell them how to do their jobs and the fact that the head surgeon suggested filling my band at my last post op appointment because I had gained weight. (He had removed my stomach tube from my surgery three weeks prior).

[Gigi_Girl 77]

FIXDF2008, Sorry you had erosion problems. Dealing with insurance is always so frustrating. Hopefully, you will get good news soon.

I just put up another post regarding my journey requesting band to sleeve. Take a look.

Gigi