Approval

I had lab band surgery back in 2006. I lost over 100 lbs. which was below my pre set goal. I had to have the band removed in 2014 due to a slip. I have gained over 60 lbs. since band removal. Insurance will not approve a new surgery (sleeve). I am considering contacting Lindstrom Obesity Advocacy. Wondering if anyone has delt with them and if thery were able to help. I would appreciate any information.

Thanks,

Kathy

First you need to know why the insurance will not approve a new surgery. 

Is WLS excluded? 

Is there a "once in a lifetime" clause?

Or are they just being a typical insurance company that wants you to fight to get the revision?

I've heard of some having their surgeries approved with help from Lindstrom. 

The reason for denial is "not medicaly necessary"  because my BMI is not high enouth...yet

Kathy, due to the insurance guidelines, you do not qualify for the surgery if your BMI is not high enough.    NIH guidelines and insurance carries state that in order to be considered medically necessary, your BMI must be 40 or greater, or 35 with a major co-morbidity (diabetes, hypertension, sleep apnea, etc).   Do you fall within those guidelines?  If so, you might have luck with an attorney, but if not, I believe even the attorney will tell you that there is nothing they can do.