Will insurance cover revision due to GERD if WLS is excluded?
The subject line sort of says it all.
I've been having acid issues and I've got a follow-up with my surgeon scheduled for Oct 16th. This seems like an on-going thing at this point for me and I know that the most plausible fix action is RNY.
However, the employer I currently have health insurance through excludes everything relating to weight loss. (******s.)
Since I wouldn't qualify for WLS now anyway, and the RNY would be solely for GERD, are they likely to cover it? Have any of you had this situation where WLS isn't covered, but surgery to rectify GERD is?
Ultimately I'll ask my insurance about this when I get there, but I wanted to know what other people's personal experience was on this.
VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)
Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170
TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)
When I was revised from the sleeve to RNY due to GERD, I did not need to lose any weight.
I was approved after the 24 hour ph test and manometry test verified severe GERD. This also "proved" the surgery was for GERD relief and not for weight loss.
My insurance does cover bariatric surgery, but again, because this was not weight loss related they would have covered it in any event.
Best of luck to you and, btw...My GERD is now gone post RNY!
Original surgery: VSG Feb. 2009
REVISED TO RNY FEBRUARY 2016
Height: 5'7"
Start weight: 252. Current weight: 120
Awesome, that's reassuring!
VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)
Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170
TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)
What are you doing to manage your remaining GERD now?
VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)
Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170
TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)
I'm glad it has improved!
VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)
Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170
TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)