Lapband was self pay; insurance may not pay for removal?

I got my lapband almost exactly five years ago. I was self pay so did not need to jump through the insurance hoops to prove that it was medically necessary for me to have it although I could have if I had insurance at the time. I wasn't employed but I had come into some money so I could afford to do it self pay. A wonderful thing so I thought at the time.

Now my lapband has eroded and I need to have it removed but my insurance is giving me the run around trying to say that I got it for "cosmetic" reasons. I guess if an insurance company doesn't give their blessing that it is medically necessary then they assume that it wasn't.

Anyway, I was just wondering if anyone had experienced this before and what the outcome was. I'm terrified that my insurance company isn't going to cover the removal of my band much less the revision surgery to the gastric sleeve that I want just because I was original self pay.

Thanks for any input anyone can provide.

I had similar cir****tances, self pay for the band and it eroded 6 years later.

My new insurance covers WLS but they refused to cover the removal of the band. It cost me $16,844 to have it removed.

They are covering my RNY that is scheduled in October, and if I had been able to wait and have both procedures at the same time my bill would have been significantly less, but I just couldn't wait.

Interesting situations because the opposite is usually true - they will pay to have the removal but not cover a revision/conversion.  We can help you appeal the denial of the removal - with an erosion they are placing you at risk.  If your surgeon has requested the removal/revision and it has been denied I urge you to contact us to evalute your options.