i hope someone can tell me what i want to hear

hi everyone
i quess i always come back when i need help. thank god for these forums. my problem is this.2008 i had a lapband surgery that was quite successful intil 3 yrs later. i had alot of vomiting and now even though my puch is wide open i still have vomiting and a nice little hernia. that wasnt there before. my drs have said since medicare paid for the lapband they will not pay for any kind of revision. can anyone tell me if this is true??? i have regaind all my weight back  

thank you so much

 There is always hope and if one door is closed knock on the next.

thank you

Maybe they will. If you are still having the vomiting and a revision is medically necessary to fix it it would seem as if that shoud be covered.  After my gastric sleeve in 2007, I developed GERD which caused some vomiting and got so bad that the acid reflux was being aspirated into my lungs. The only way to fix it was with a revision to convert to a gastric bypass and that they had to do no matter what my weight was. If they did not do it, my lungs would have continued to scar and I would have gotten to the point where I could no longer breathe.

Although my insurance did NOT pay the first time because it was elective, they did pay the second time (after a brief battle) because I had tons of documentation from other doctors detailing all the health problems including chronic pneumonia, bronchitis and hospitalizations that I needed the 2nd operation to fix.

I don't know the details of what you are experiencing, but if it's a current medical issue you are having that is seriously impairing your health and you can document it, you may be able to have it reviewed and paid for. I'd talk to doctors other than the bariatric ones as to the state of your current health with what you have going on. Maybe a GI.

Good luck! Some people have successfully sued if it's necessary to their health.

 I called Medicare 4 times to speak with 4 different people to make sure I got the same answer and what I was told (by Medicare and a surgeon I spoke to ) that Medicare treats revisons as seperate surgerys. That as long as I meet the requirements my revision surgery will be covered. I was told it does not matter if Medicare paid for my inital surgery or not. I have heard another poster say that in her state it does matter but she is the only one I know of that has said it matters in her state. Medicare is a federal program and should be the same program benefits nation wide. I would call Medicare and ask them before I took a surgeons word for it.  Regardless though, if you tried the lap band and now have a hernia I would think that qualified as a failed surgery that needed to be corrected. I think some offices get confused on insurance requirements. For example I asked Medicare if I needed a referral and they said no, just like I don't need a referral for other appts. I spoke to several surgeons offices for what was needed to get started and of those several one was adamit that I needed to have a refferal from a PCP in order to even get a first appt. That it was not the office that required it but Medicare. They are wrong and confused about what Insurance they are speaking about. But thats okay it was an easy request. You could try to correct the benefits person or just go somewhere else.

i sincerely appreciate your response because my drs have refused to do the surgery unless i pay 17,000.00 cash which i dont have. another surgeon refused because i had the surgery in another hospital i feel like the rock and the hard place for sure. i am so happy to hear that it is possible.

thank you again

Can't help with the Medicare part but honestly don't go by what the office staff says because at least half the time they don't have a clue what's going on. It's kinda like dealing with Tweedle Dumb and Tweedle Dumber! There has to be a doc somewhere that will see you, keep trying and don't give up. Be the squeeky wheel and make them work for you! Wishing you all the best!

thank you so very much. i wish i would have returned to this forum months ago instead of accepting the drs word. i actually called the hospital where i had the surgery, my dr was not the whole weight loss center as i had been led to believe. i have an appt on the 6th and she said shes pretty sure medicare does cover revisions YAY Me and thank all of You for always being there for each other God Bless all of Us and Our Journeys

I had the same problem!! I had a band for almost 2 years .. ..worked at first, but never could do a good fill..i would get fill, throw up. get unfillled..went on for months.. finally found i had a heria too. ..they had to let all the fill out due to thevomiting....and i gained about 20 lbs.. back.. now i still had kept 50 off but did not want to gain it all back..  well my insurance company paid for the band- and would even pay to have it removed, and hernia repaired, but NOT the revision to the sleeve.  however, since my doc had to go in their anyway, he gave me a discounted rate.. i even got him down more because you can get sleeves around here from 9500  to 11000 cash- so he went down to 10K.. my insurance company would not cover the sleeve now because i was not high enough bmi.. go figure.. they have all the cards don't they?/ but i bit the bullett and paid for it.. i think if i would have done it 2 years ago i would bre finished losing my weight! but guess this was a good practice run for the sleeve..i know what to expect and was not as scared.. good luck what every you do.. i am 3 days post op!!!

Medicare paid for my revision.  Like the previous poster said, as long as it's medically necessary they will pay.  If they are that misinformed I would find another surgeon.