Dreaded insurance ?

I had RNY surgery nearly 6 years ago. I was never really content with the results. I was able to eat much more than supposed to with no adverse effects. Long story short...I was 330# preop. Lost 100#. Have gained back 50#. I started a new job 3 yrs ago and contacted the insurance provider to aknowledge about surgery and they informed me that wls was not covered. I have since been hiding from the issue and becomming more depressed as time goes by. I don't even tell my closest friends that I have had wls.

My question is...is a REVISION looked at any differently by an insurance company?

I've even thought of changing jobs in order to change insurance...pathetic!!!

Angela H.

Angela,

Your insurance company may cover a revision if they deem it medically necessary due to staple line disruption, stricture or some other mechanical failure or the previous surgery. Also, alot of states make insurance companies cover WLS you may have to appeal it a few times ..... talk to your baratric surgeon and also check out conversion to a DS (check DS Forum).

Scott

Hi there,
Some insurance companies will cover revisions, you have to look at your policy to see if it will.  If you were 300 and lost 50lbs, you'd still be eligible from a BMI perspective, but none of that matters unless your policy specifically covers revision surgery.  Hang in there and best of luck on your journey, don't be discouraged, get out there and fight for what you want.  I also had an RNY in 2002 - lost 175 lbs, gained 180lbs.  Wasn't able to get my insurance to approve it so am going to self pay.  It's a lot of money, but I can't stand living like this.

Debbie M.

Def. check your insurance policy out. if it doesn't ..............change. It may be worth it. Some have different guidelines for approval as well. Best thing to do is to document everything in the meantime. Anything that you have going on like comorbidities..... try a doc supervised diet again for 6 mo..... get all your chickies lined in a row so when they say hey... you need to have done a..b and c... you will already be there.
But above all else, get an endoscopy done by a gastric surgeon. You may not even know you have things going on inside that could be 1..stopping you from losing or getting that full feeling anymore and 2.... any medical issue that may be there that will need to be repaired and will also help you to get approved even better. Especially if you are not 100 plus over weight again. Any little thing helps! Good luck!