Insurance ?- Non Mechanical Failure of Lap Band for Revision to DS

VelvetKiss
on 10/5/11 4:05 pm - Broadview Heights, OH
I have decided to proceed with using Dr. K and I have tried searching on the boards and google for anyone who had insurance cover their  revision from Lap Band to DS, but did not have a mechnical failure of their Lap band.  I have medicare and my insurance is BCBS of Oregon, Medadvantage plan and they say they cover revisions as long as it meets medicare's medical necessity and I meet that but I am concerned that they will not approve due to no mechanical failure of the Lap Band.  Any help would be greatly apprecaited.

Thanks!
Tonya
(deactivated member)
on 10/5/11 10:28 pm - Bayonne, NJ
If they cover revisions and you still meet the original bariatric surgery qualifications, it should work. So, if your BMI is 40+, or 35+ with comorbidities, you qualify. Having a high BMI is a medical necessity.
(deactivated member)
on 10/5/11 11:07 pm
VelvetKiss
on 10/6/11 2:26 pm - Broadview Heights, OH
I was told that BCBS does cover revisions and they follow Medicare's Medical Necsssity guidelines.  I meet all of those, but I just dont feel BCBS will approve that easy.  I hopeing they dont give me issues about no mechanical failure of my Lap Band.  That is the reason I have seen on the boards for people not getting approval.  Time will tell.  Thanks for the adivce.
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