One WLS per lifetime covered

I was thinking about a revision but contacted my ins co and was told one WLS per lifetime.
Anyone else have this issue and get approved for revision?

Long story why I need/want it. I was researching if it was possible and hit this wall.

It's basically no longer a covered procedure for you.  This can even apply to a self pay person.  If someone self pays for their original surgery and later has ins that covers WLS, that's too bad.  The person had their once in a lifetime WLS.

Welcome to the world of self pay.  :(

Sometimes I don't blame the ins co's.  I've seen countless times on various boards people say something such as if the band doesn't work they'll just revise to bypass.  Or if the sleeve doesn't work they'll just revise to DS.  Ins co's really shouldn't have to keep paying for surgeries in those cases but, some ruin it for everyone.

What revision do you want?  Sleeve?  Bypass?  DS?  Mexico can potentially be a good option for half the cost.

Thinking about sleeve. Being in MD, Mexico is a long trip. I guess I'm just going to have to suck it up and deal with it. I can barely pay my bills as it is. The airfair alone to Mexico would be impossible for me.

Most people fly to San Diego, depends on where your surgeon is.  But I know, money is tight for most.

Most ins co's are going to the once in a lifetime WLS.  You are not alone.

I love San Diego and if my husband would go, I'd live there forever. Then I could just take the 10 min trip over the border. I was there in Sept and I saw how close it is to Mexico.

HAHA!  Noooooo, you don't want to cross the border there.  That is Tijuana, MX.  You want to drive through CA for a bit and cross at a safer city.  But yes, the border to TJ is about 10 minutes from the airport.

On December 31, 1969 at 4:00 PM Pacific Time, wrote: Sometimes I don't blame the ins co's. I've seen countless times on various boards people say something such as if the band doesn't work they'll just revise to bypass. Or if the sleeve doesn't work they'll just revise to DS. Ins co's really shouldn't have to keep paying for surgeries in those cases but, some ruin it for everyone.

My insurance has the 1 per lifetime yet they approved my revision. They wanted evidence of problems with the band. The place to start is with the surgeon. I didn't even have UGI evidence of a problem yet when the surgeon said it had to go the insurance guru went to work. I thought it would take multiple appeals but 4 weeks later we were scheduling my date. The biggest problem I have had with the process is paying my share. Not going well.

My insurance had the same "one wls per lifetime" policy too. But, they make exceptions for revisions that are medically necessary. Now, not all policies do that, you may want to investigate if yours does.

 

My insurance has the once per lifetime too.  I was able to prove medical necessity and was also approved.  I'm getting my sleeve Tuesday God willing.

I was checking out Mexico also while fighting the insurance. (I got information on the failed band group how to fight).  I had it down to a couple doctors.  I spent from July to November on the Mexico boards here reading way back to get all the information.  I also spent time on the Canadian boards as many go to Mexico even though covered as they have 2-15 year wait time depending on the area.