Does insurance paid for revision?

[Kiki Von Moonshine 53]

I'm curious, as to what the rules were with insurance companies that paid for revisions?

[JoiaRox 430]

Depends on a couple of major things:

1. Your insurance company's policies.

2. Whether or not your doctor will do a revision all at once, or will require you to do it in two, separate surgeries.

My insurance covered my band removal in March, and my doctor wanted me to wait 3 months before sleeving so that my stomach would heal - I had massive scarring and a heavily distorted stomach from living with a severe slip for 2+ years (long story as to why!).

As soon as the band was removed, we began the process of getting insurance approval for the sleeve - at that point, I was considered a "new patient" in that I had to meet all of the WLS requirements as if I'd never had the LapBand. Luckily, the process was QUICK and didn't require too many hoops - I was sleeved exactly 11 weeks after my band was removed.

[Kiki Von Moonshine 53]

Oh, okay. I plan n calling my insurance but I have a history with them and the misinformation. Will call them when the holidays are over. My surgeon doesn't perform the surgery I want, so that's out of the question Thanks for responding.

[Kiki Von Moonshine 53]

So I'm assuming I'd have to do the six month process like I did with my first surgery?

[JoiaRox 430]

So I'm assuming I'd have to do the six month process like I did with my first surgery?

If you have the same insurance, that's probably a good guess. I didn't have to, with either my band or sleeve - two different insurances, but every insurance is different! I just lucked out

[NikNakMcCants 62]

I was a band to sleeve revision. I had no problems with my insurance company (and I even switched surgeons and hospitals). I had my removal and revision in one surgery on June 10th. The whole revision process took me 4 months. I had to have my physicians approval, blood work, an EKG and a new psych eval because my last one was in 2009.

[marfar7 1,528]

My insurance (Medicare, I'm a disabled vet - not 65) will pay for revision if there's a complication with the band. and they will only pay for it if it's done AS a complication, meaning at the same time as they remove the band, they do the sleeve. If they get in there and my stomach is too damaged to do the sleeve and I have to wait, they won't pay for it cuz my bmi is only 29. I'd have to gain another 50 lbs to be eligible for revision. And I'm not gunna do that.

I'm praying to wake up sleeved in the recovery room on July 16th. otherwise I guess it's a future of dieting, and we all know how that turns out...

[Fixerupper 335]

My revision did not require me to start over. It was covered fully and immediately as a medical necessity.

[Nursebarbie 392]

Mine covered it completely since the band slipped. I have Kaiser and the surgeon said he gets to make the decision. Really relieved about that. My lapband ordeal outside of kaiser was and has been a nightmare! So glad its out and I'm sleeved. One week post op.

[brandibandtosleeve2012 12]

It took me over a year to get insurance to approve revision. Initially they approved removing the band, but not revision. It took a year of regular visits to the surgeon to check in and show no weight loss. We resubmitted the paperwork and the insurance approved in 2 days! Just don't give up. Best wishes to you.

[piercedqt78 658]

I had a slipped band and was covered all in one surgery. My policy states that I cannot have lost more than 50% of my access weight. I did not require anything else, other than the doctor writing a letter, since I was unable to keep anything down, including most liquids, he did a phone interview, and they did a rush review. He stated to the insurance that if not I would need to be inpatient while they made up their minds, since it was 90+ degrees here and I was unable to take in fluids. They approved me on the spot, I had surgery the next day.

[Nursebarbie 392]

Very good! My band had slipped too and couldn't keep anything down. Had surgery a week later. So glad this band is out and have a new sleeve!