Insurance Covering revision

So, I have a documented large pouch and wide open stoma, my surgeon said food is going right through like there was no surgery done. I have Wellmark BC/BS insurance, am I going to have a hard time getting a revision paid for or is this considered a mechanical failure.  I do have other health issues such as PCOS, oseoarthristis and possible sleep apnea (failed the overnight oximetry and now having full sleep study).   My surgeon seemed pretty confident that we wouldn't have a problem, just wanted to know other experiences.  Thanks

From what I have been told the large pouch and the wide open stoma is considered mechanical failure. I am currently going through the same thing but remember there will be some hoops to jump through.

sophia

I'm going for my floro. tomorrow and I'm anxious to see what the "problem" is as to why I have no restriction in an almost full band.  I hace BC/BS of AZ and according to my policy (that I just confirmed yesterday) it said that one of the medically neccessary reasons for revision that bc/bs approves revision for is failure to lose weight due to expanded pouch or stoma...so that sounds exactly like what you said. 

I have PCOS as well, do you think that has anything to do with the weight loss failure?  I was wondering about that myself. 

Also, was your band filled to the max before they diagnosed/documented it as not working? 

Good luck!