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Advice.

Hi. I am looking for some advice. My daughter is working to meet insurance requirements for revision surgery. She has PCOS and severe early onset arthritis caused by an accident several years ago. We didn't know that the band isn't very effective for women with PCOS and although she lost 60 pounds right after the band, she has slowly put it back on over the last year or so. She hasn't had her band filled or gone for a band check in over a year as she has a hard time even getting 6 oz in at each meal and most times doesn't even eat 3 meals a day. When she had her band, her dad's insurance covered it. Now that she is 21, I put her on my insurance. My question is, will my insurance see the procedure as a new procedure or a revision? What are the chances of her getting approved without regular band checks/fills? Thanks for any advice you can give.

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Yes it's still a revision, first surgery with them but still a revision. If it was me, I'd get back in with my bariatric surgeon ASAP for a possible fill/unfill and to discuss options. You want her records to show that she is currently actively trying to lose weight...

Good luck!!! Life without that stupid band is heaven!!!!

HW 312, pre-op (lap-band) 294, pre-op (RNY) 255, surgery date 2/11/13, goal weight 154, current weight 231.4

  • Author

Thank you for the advice. I will get her in to have the band checked.

I have MVP insurance and they will.not cover a revision. Regardless. I still have my band but will have to swap insurances come open enrollment in nov at my job. I would call your insurance. :)

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