Will insurance cover revision due to GERD if WLS is excluded?
This is a really interesting topic that I don't recall coming up in the past. Please make sure to keep everyone posted as I'm sure your experience will be useful to others. I had an RNY initially (partly do to existing GERD issues), but I'm still very interested in your outcome. Best of luck!
There are lots of posts on OH from post-op patients that develop GERD or it worsens after VSG surgery. As well, many people have insurance that doesn't pay for more than 1 weight loss surgery or their insurance changes after their first surgery, which makes getting a revision difficult. This is why a number of people have to self-pay for WLS.
Same answer as you've provided to many newbies over the years:
Others' personal experiences don't mean a darned thing. Call your insurance company and ask :)
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
Others' experiences definitely don't tell me what my insurance will do, but they're still reassuring and informative for me to hear!
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 reason were you given for the denial?
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)
Interesting. Thanks!
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)
My insurance does not cover weight loss surgery, but because the GERD was deemed medically necessary, it was the exception to the rule. My doctor submitted all the paperwork showing all the different options we tired before deciding on revision. This included an upper GI study and EGD as well. After everything was submitted, it took about a week to get an approval. Hope that helps.
Thanks! 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)
