Insurance coverage for a revision

I was told by a nurse ( not at my practice) That the insurance co. will not cover you for a second surgery, unless there's some type of damage or something went wrong with the orginal surgery. I want to know if this is true?? So I must need for my band to slip,or have something wrong with my esophagus(sp) for the insurance to cover my revision. Please share your insurance difficulties with me. I have Trigon Blue Cross and Blue Shields Cova Care PPO. Thanks  Tonya

I think it has more to do with who your insurance carrier is.  I have federal blue cross blue shield and they tend to be one of the better insurances out there.  If your BMI is over 40 or 35 with commorbidities I think you can qualify for a revision.  Don't let that one nurse discourage you.  Find a wls office that is willing to help you fight for surgery.  Good luck with fighting this battle I know it is not easy.

Thanks Darnell, my BMI is 41, but I don't have any other commorbidities. I'm working with the office where I had my band, but my surgeon has since moved to Montana so I'm dealing with one of the other surgeons there and he seems to be dragging his feet with this whole process. I just want to move on with my life and my weight loss. Thanks for your help. Tonya

Tonya, This new surgeon doesn't seem to be to motivated to help you.  If I was you I would find another doctor who wants to help.  Get a copy of your surgery notes find a new doctor and try and get the ball rolling.  Your BMI is over 40 and that is in your favor.  Also, if I was you I would say that I have back and knee pain due to carrying this excess weight.  Being over weight does cause back and knee problems.  I hope this helps you.

I like the way you think  that's what lead me calling another surgical group when that stupid nurse told me the insurance will only cover one surgery. But, I actually spoke with the coodinator at my office today and she assured me that the doctor is working on my case. So I'm trying to be patience but it's hard when you wants this so much. I used to be so dead set against RNY, but after going through all of this really makes me want it even more.

Research all of your options. I wish I had. I had RNY and I wish I had searched all wls procedures and then made my choice. I am looking into a revision from RNY to DS. Good luck. The best things you can do for yourself is to be informed! Samaria

Hello Tonya, I have BCBS PPO of Maryland and I had a revision last Wednesday and they approved it within 24 hours of my surgeons office submitting my paperwork.  I agree with Darnell about BCBS being one of the easier companies to work with.  There was no mechanical  failure either.  I would get another surgeon who seems more interested in helping you accomplish your goal.   You will find a surgeon who is willing to work with you and advocate on your behave.  Good Luck Shawnta

I have BCBS Federal and I am hoping for positive results.  My BMI is 39 and I had lap band and want to go to rny.  I am always hungry.  (3.6 out of 4cc)  

If your BMI is over 40 or 35 with commorbidities you can qualify for a revision. Just start jumping through the insurance hoop again, your surgeon should be able to guide you. I was just revised from an RNY to the DS. I gained back 100 lbs My endoscopy showed that my Stoma streched.