Need help getting my mom's surgery approved though insurance

jaymad1987
on 9/28/15 3:47 pm

I got my mom insurance through Obama care with blue cross blue shield of Texas it's a blue advantage silver hmo plan. But she couldnt get approved for the lap band surgery from true results through her insurance. But true results wouldn't point us in the direction of an insurance provider that could or would cover the surgery. And we are willing to change insurance providers in order to find one that would cover all or some of the surgery. Any help or experience dealing with insurance companies and lap band surgeries in Texas would be greatly appreciated. 

Neesie57
on 9/28/15 10:48 pm
VSG on 08/04/15

Please do some research on lap band versus other weight loss surgeries.  It has more complications than other WLS surgeries with a high rate of failure.  My doctor says the only time he does lap band surgeries is to take them out. 

Look into vertical sleeve gastrectomy, gastric bypass and duodenal switch, and compare the success stories.

Good luck!

5' 5" tall. VSG on August 4, 2015/ Starting weight 239.9/ Surgery weight 210.9/ Current weight 137.4/ Goal weight 140/ No longer overweight, now a NORMAL weight. Now that I'm at goal, it's time to move on to maintenance!!!!!!!!

 

 

 

ladygodiva1228
on 9/29/15 6:01 am - Putnam, CT
Revision on 02/04/15

Unfortunately many insurance companies are doing away with covering the lap band due to the high rate of complications and revisions.  Now don't get me wrong there are some very successful bandsters, but most folks including myself are revising to another form of WLS due to the complications.

I would strongly urge you to have your mom look into the WLS that are out there. 

Best of luck.  

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

Hislady
on 10/2/15 9:45 pm - Vancouver, WA

You are fortunate that they refused True Results as they are a very shady outfit look on the internet for True Results scams, they are not a reputable outfit. They promise you the moon and give you nothing in the end. You may have trouble finding insurance that covers bariatric surgery. There seems to have been a misconception that Obamacare would provide bariatric coverage for everyone when in fact hardly any plans do. The few that do cover it are extremely expensive.

All you have to do is call your provider and ask if it covers bariatric surgery and if so who in your area is covered. The place to start is your insurance, if they don't cover it then you need to go to where you got your insurance and talk to them about coverage that include the surgery because fewer and fewer places cover it. Did they tell you why she wasn't approved? Maybe the insurance just doesn't cover True Results as I said they are a shady outfit. The insurance company has to send you a letter telling why she wasn't approved so that may be the place to start.

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