Trying for approval from Lap-Band to RNY - very frustrated

[mom2sparky 2]

I am so frustrated. My United Healthcare policy will only pay for a revision if there is a malfunction with band, which means I have to get some kind of scope to see if this is the case. The surgery coordinator at my surgeon's office informed me of this yesterday, when she could have informed me last week. For whatever reason, the surgeon won't order this scope, I have to go to my primary doctor and request one, which wastes more time. However, I am going there next week, and I am sure one will be ordered right away. Problem is, there is probably not going to be any kind of "malfunction" with the band. I doubt it has slipped, and I would assume I would have noticed some symptoms if there was erosion. So if this scan turns out normal, I am screwed. Never mind that I have type 2 diabetes and severe sleep apnea, and the cost of my healthcare will be more expensive to UHC to shell out money for my medications, when this surgery could help end these problems. Has anyone else experienced this problem? Thank you in advance.

[kiwi201000 40]

I gave up on trying to get my insurance to cover it and am in the airport as we speak heading to Tijuana. $6800 for band to bypass revision... I didn't want to jump thru all the insurance hoops anymore.

[Pinkgirl1234 761]

Yes insurance puts you through the ringer.I was having pushback about tests etc. Finally went to the ER after one of my vomiting episodes.It forced them to do an upper GI an they uncovered a mild hiatal hernia.Then had to go to my primary to get a referral for an endoscopy.He found nothing.Had the band unfilled.It only had 2cc's to begin with...ugh.I was told I had a "torturous esophagus".It was in the report! I am going through all the hoops...just saw the pulmonary doctor and he is recommending me for a sleep study....sleep apnea he thinks...now gotta see if insurance covers in home or clinical.Had a stress test.Insurance denied Echo and the nuclear stress test so I had basic.Now I am trying to find a Psych for evaluation.Very few want to accept insurance and scheduling is an issue.I am going through the hoops but I don't have money to self pay.