United health recently denied coverage for fills.

hi all, I had lap and surgery 2011.  Through last year my insurance paid for the fills.

However this year 2016 the insurance will not cover them due to Doctor writing my diagnosis 

"morbid obesity".  I have gained a great deal of weight and am as a lost what to do.

Has any in countered this?

thanks.

omar88

Hi Omar

I'd explain to your Dr. that his Diagnosis is preventing you from getting the proper treatment that you need. He can also do a Peer to review of your case and it basically challenges the insurance companies decision and the Dr. gets the chance to state why it's necessary for you to continue with Fills. If that doesn't help try to challenge the insurance company in that IF the band was placed due to morbid obesity then how can they say NOW they don't want to cover your Treatment?

BE your own ADVOCATE and don't just take their decision as Gospel, it's often reversed with a peer to peer reviw of the case .

 I hope you get this worked out!

I would strongly urge you to try to revise to a sleeve, RNY or DS weight loss surgery. As long as you have a band you will continue to gain weight. Does it cause voimiting or reflux(heartburn)? Just the fact that you are unable to lose weight with it is cause for a revision to a different surgery.

The band has a 60% failure rate and most of us have had ours removed, some have had a different surgery and some like myself have simply had it removed because we are unable to have another surgery for one reason or another. It is very common for the band to slip or erode into the stomach after a few years. They might cover a rewvision where they won't cover fills because many insurance co.s will no longer cover the lap band because of the high failure rate. Keep trying don't give up!

True.

It is actually 60% of bands are removed in the first 2-6 years.  The stats are higher after that.