Insurance not wanting to do revision

Karla S.
on 4/7/10 11:28 am
My band has to come out.  My Dr. thinks going to a sleeve is best for me.  I want to do it.

My ins. says they will cover band removal and...putting in a new band.  Says that there is a "one per lifetime" limit on bariatric surgery in our company policy.

I know I can't do this by myself.  I know I can't afford self pay.  I know the likelyhood of problems increases after having problems with the first band.

SO.....what do I do???  Has anyone encountered this kind of thing with their ins. company before??  Is there a chance to get it approved, or should I just deal with what I've been dealt??


(deactivated member)
on 4/8/10 2:18 am - Bayonne, NJ
You didn't fail, the band did. If you can't appeal, use a lawyer. Walter Lindstrom at Obesity Law does very well, and he's reasonable.
Ms. Cal Culator
on 4/8/10 2:31 am - Tuvalu
There might be a one-per...but even if there is, having the band come out MIGHT be something they have to cover if there is a demonstrated health problem involved.   

What state are you in?  
Karla S.
on 4/13/10 2:18 am
they will pay for removal and to put a new band in, just not the sleeve i wanted.  oh well, its their dime if they have to keep doing this....
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