Revision & Health Insurance

I had Open RNY about 4 years ago and have gained back about 35 lbs. I never got to my desired weight. I still have about 110 lbs. more to lose. I have been thinking of Revision Surgery and was wondering if anyone knows if Anthem Blue Cross/Blue Shield would cover it. I have been in counselling for about 8 months now to learn about my "eating habits" ....I wish I had more counselling before my surgery. Now I know I was not ready for the surgery then. But Now that I have had all these counselling sessions I am ready and know I will not make the mistakes I made the first time. Any answers/help out there.????

Hi Laura, I also have Anthem and checked online for their Medical Policy regarding Gastric Bypass and revision. I'll send you the entire policy to read through (if I can - it's a PDF file), but I'll just paste the tidbit about revision below. It's best to talk to a surgeon about this first and then see what you can do about insurance. The surgeon will probably be able to tell you if you're a candidate for a revision. For revision of a gastric restrictive procedure for clinically severe obesity, there must be documentation of a failure secondary to a surgical complication such as fistula, obstruction or disruption of a suture/staple line, and is subject to the same criteria listed above. The criteria "listed above" was medical necessity - BMI over 40 or 35 with co morbidities, etc. I'll try to send it to you. Michelle