11 years W/Lap band needing possible Revision. Insurance?

I had the Lap band put in in 2004. Self pay due to policy exclusion. Had to have emergency revision in 2007 and my insurance covered it even though my insurance had the Bariatric exclusion. I've had the band 11 years and have the same insurance plan with the same Bariatric exclusion and erosion is suspected. I will probably need a revision to sleeve or RNY. Does anyone know what the odds of my insurance covering this are? I know Bariatric exclusions typically never cover Bariatric procedures. It was a huge surprise when our plan covered the revision in 2007. I do have Medicare part a and b as secondary insurance and have heard that they do cover revisions. And if they are secondary they will cover of primary does not cover due to exclusion. Can any provide information? I would be very appreciative. Thank you in advance!

Best way to find out is to call your primary and talk to them and then call your Medicare and talk to them. That is the sure way to find out.

If your primary doesn't know - contact the surgeon you would like to do the work - they may have ore experience.

I had the lap band in 2009 and revision to RNY in July, 2015. My Medicare part A and B paid 100% of the cost. Since Medicare is not your primary, I would call them to find out if they would pay as secondary. You might also check the Medicare handbook at Medicare.gov. That is where I found they would pay for the revision. Good luck!

Call the numbers on the backs of your insurance cards ASAP! You can't live with a hole in your stomach/ "erosion". Even if they just pay for removal move fast. Most likely you will NOT be able to revise during the same time of band removal with the condiditon of your stomach "erosion". Your stomach needs to be repaired first and heal for some time. Yes you can find an ambitious surgeon to do all in 1 shot but you have to live with your body for the rest of your life, and generally it is just not the way to go. Besides you've had that band in you for 11 years - there is not a chance that you won't need scar tissue dissection and removal.

Typical signs and symptoms of an erosion:

-Oozing from the port-site incision.
-Upper abdominal pain.
-Vomitting.
-Decreased oral intake.

The band erosion can be identified by your doctor via:

-Endoscopy
-CT Scan
-Upper gastrointestinal series
-Abdominal X-ray
-Endoscopy is the most invasive but it identifies 100% of erosions. CT Scan's identify about 80% of erosions and abdominal X-rays only identify about 25% of band erosions.

Good Luck with everything!

If you've got erosion, you definitely want to get that band removed as soon as possible.

Hope you're okay. Best of luck.

In most cases, secondary insurance does NOT cover anything your primary insurance doesn't. Anything your primary insurance covers, your secondary covers your deductible and co-pay. At least, that's the way mine works.