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I’ve been approved for a revision



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It’s been a while but I’m back. I have been suffering from GERD and Regain. Insurance fought me all the way but I was finally aloe for revision. Meeting with my Surgeon next month, hopefully to set date.

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That's great news for you and well done on fighting for your rights on this!

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Thank you. Trying to figure out this app tonight. So much has changed in 7 years. Lol

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So can I ask a question? What are the insurance criteria for revisions? You're under 40 GMI now, but you have GERD, so is that a comorbidity? Are the approval requirements for a revision different than for original surgery?

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1 hour ago, GradyCat said:

So can I ask a question? What are the insurance criteria for revisions? You're under 40 GMI now, but you have GERD, so is that a comorbidity? Are the approval requirements for a revision different than for original surgery?

I know you didn't ask me this, but some insurance companies will approve revisions if there's a medical reason for them. So GERD would count...

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A hernia or acid reflux could be qualifying conditions.

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Thanks everyone. Insurance criteria varies by providers. Most want it to be “medically” necessary. Surgery failure, weight gain, complications etc. I used a medical advocate to gain approval.

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8 hours ago, Glorious Release said:

Thanks everyone. Insurance criteria varies by providers. Most want it to be “medically” necessary. Surgery failure, weight gain, complications etc. I used a medical advocate to gain approval.

if any approve it for weight regain, I'd think they're few and far between. I haven't heard of that, but you may be right. I know some will approve it for medical reasons, though - like GERD or other complications that can't be "fixed" through more conventional means. And many won't cover revisions AT ALL (like mine...luckily, I haven't needed one). I have a friend who's suffered horribly for the last couple of years from a 10-year-old lapband. It worked fine for a few years, but not anymore. Her insurance company won't budge. I feel horrible for her.

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