Anthem Blue Access PPO and revisions?

(deactivated member)
on 11/16/08 7:25 pm - Elizabethtown, KY
When I had my rny 3.5 yrs ago I had Great West.  2 yrs ago my husbands company switched to Anthem Blue Access PPO and since I've been researching having my rny revised to a DS with Dr Husted, I called Anthem to see what their criteria might be.   They "say" that they are pretty easy to deal with but u never know with these insurance co's.  Anyone know anything about Anthem and their revision coverage?  They said something about a $200k lifetime limit for weight loss surgerys. 
Thanks for any tips!
Vicki Browning
on 11/20/08 1:59 am - IN
Angela here is the Anthem policy for revisions:

Surgical repair following gastric bypass and gastric restrictive procedures is considered medically necessary when there is documentation of a surgical complication related to the original surgery, such as a fistula, obstruction, erosion, disruption/leakage of a suture/staple line, band hermiation, or pouch enlargement due to vomiting.

Not Medically Necessary:

Stretching of a stomach pouch formed by a previous gastric bypass/restrictive surgery, due to the patient overeating, does not constitute a surgical complication and the revision of this condition is considered not medically necessary.

(deactivated member)
on 11/20/08 7:11 am - Elizabethtown, KY
Thank u Vicki!
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