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Part Ins Part Self Pay

I currently have the band. I want revision to the sleeve due to being unable to keep a fill due to acid reflux. My insurance (BCBS Fed) will pay for the removal of my band, but want me to do all of the pre surgery approval checklist things before they will agree to paying for the sleeve -

2 years proof of morbid obesity

Letter of Medical Necessity

Psychological Evaluation

3 Months of supervised visits for withg management

Consult with surgeon and nutritional evaluation

I do not have a problem with any of this except for the 2 years of proof of morbid obesity. My band was completly unfilled last year, at that time my BMI was 33, have to have 35. I have gained 60 lbs in the past year so my BMI is now 40. So I only have the one year.

My question is.... has any one had insurance pay for removal of the band and then self paid for the sleeve, all in one surgery? I have left a message with the surgeons office to see if they will even do it. I just want to get it done, I am so very unhappy with myself. I had really done good with the band, I loved my tool.......

Thanks all

Laura

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Just thinking, make sure you discuss your reflux problems with the doc -- the sleeve is sometimes considered to be a bad choice for someone with this issue. You probably heard that before but I just wanted to mention it in case. :)

  • Author

WOO WOO - I only have reflux when the band is filled no issuse since it being unfilled. I did discuss this with the doc because I had read that the sleeve was not good for someone with reflux. He said he did not think I would have a problem. Thanks for asking......

  • Author

Talked with Doc office. They have submitted my request to the insurance company. They told me that they have done this before, so it look hopeful. I was also told that I should have an answer in the next two weeks.

Hopefull

Laura

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