so tired of being fat
Tammy I feel your pain! My band is not working for me either. I would love to be able to revise, but I don't have insurance and I wasted a LOT of money on this POS! :-(
If I am not mistaken, I think Medicare will pay for revisions. As far as Med-i-cal, I have no idea.
If your Dr. is reluctant to submit the letter, is it possible to change Drs.??? Either way I would suggest you have a serious talk with your Dr. and tell him what you need. BE FIRM! He is suppose to have your best interest in mind. Sometimes we have to be very assertive with healthcare providers or we can "slip through the cracks".
When you speak with him you might also want to give him a copy of this:
www.medpagetoday.com/MeetingCoverage/ASMBS/20919
If he hasn't read that yet..............he should have!
Good luck!
On March 31, 2011 at 9:13 AM Pacific Time, Tammy R. wrote:
Thanks Maria for feeling my pain. My surgeon recommended me get the rny instead, but I was afraid. I dont know what to do, now Im afraid if I dont get this weight off I wont live to be very old:( I may have made the worse mistake of my life.My health was not bad but I know it would have gone down hill if I stayed at the weight I was, so I understand. Very scary! :-(
Keep us updated on what happens with your Dr. of if you change Drs.
Whatever you do I would suggest trying to get it done quickly b/c there are many insurance companies that are starting a "one WLS per lifetime" stipulation in their policies. With so many bandsters that need or will need revisions, I fear that a lot will not be able to get them in the near future b/c of the increase on the number of insurance companies starting this!
Yes I know! I hate it that so many ppl will miss out on a 2nd chance at an effective WLS b/c of this! That is just another reason why I get upset with some of the bandsters that keep tellling the bandsters that have had it awhile and it's not working to just keep following band rules and it will work. It will work for SOME............and for the ones it doesn't work for............I just hate the thought of them missing out on having their revision covered b/c of listening to them!
Very glad that you got your in time!!!
I had revision surgery in January 2011. My insurance approved and paid for my revision surgery. They approved it within 1 week. I have Cigna/Great West. My doctor had to basically lie and write a letter that I was having all these complications and etc., but really my band had just slipped down and was allowing me to eat bigger portions. It had to be corrected in order to make the band work. I had to pay my yearly deductible of course. If you have a flexible doctor, he should be able to submit a letter to the insurance company explaining why you need this. I didn't actually get to see the letter my doctor submitted, but it's a template he uses for all his lap-band patients and he deals a lot with the same insurance companies, so I imagine they get used to seeing the same letter all the time. however, with all that said, I don't know about Medicare or Med-i-cal. I imagine that's a tighter rope to walk, but I would push for it. I thought the revision surgery would be cheaper than the 1st surgery, but my doctor charged the same for the revision one - $15,000+. I don't know if it's any different if you are paying out of pocket.
Good luck and don't give up. :)
Good luck and don't give up. :)