Soooooooo frustrated!!!!!!!!!!

So I had my EGD Tuesday.  Like I figured, something was indeed wrong.  My stoma is enlarged.  My pouch is still tiny which only confirms what I already knew.  I did not stretch the stoma by overeating or drinking while eating.  It was a mechanical malfunction that needs to be REPAIRED.

Now get this, My dr says Medicare will not pay for a REVISION and wants me to pay 5000 to fix it.  I dont have 5000...nor will I be able to find that kind of money to fix it.  I called other bariatric dr's and NO ONE wants to touch me.  They all say to go back to my original surgeon.

Called medicare and since they don't preauthorize anything and they say the dr needs to call them and talk to a CSR to help them. 

Meanwhile, I'm stuck in the middle with a broken RNY, that I did not cause, and no one wants to help me.

What do you want to revise to?  Do you just want to keep your RNY? What is your BMI? Or do you want to choosed a different surgery?  Yuo might get insurance answers on the surgery you want to have done.  You might get more responses on that particular board.  There is also an insurance forum as well. 



Good luck & keep us posted!!!!
-Jamie in Alaska

I'm pretty sure the revision my surgeon is talking about is to fix the enlarged stoma, extend the rny and repair the hernia.  $4000 for the revision and $1000 for the hernia repair.  My BMI is 34 right now.  I am 5'4.5 and 203 pounds.  I have no other health problems other than I still may have sleep apnea.  I need to do another test as I am still having lots of trouble sleeping.

I will check out the insurance board. 

I want to make it clear that I am not looking to be revised in order to lose weight.  I just want to be repaired so that I don't GAIN anymore of my weight back and so that the original surgery I had will work properly and do what it was originally supposed to do.

I just feel lost and abandoned.  No new dr wants me and I don't have the $$ to pay my original surgeon to fix me.  I am disabled and can not work due to my disability.  If I could work then I wouldn't have Medicare and would probably have the $$ to get repared. :-(

Medicare DOES cover revisions---but your BMI has to be over 35. Have you called Medicare yourself?

Jill don't give up, no one wanted me as a revision either, I had to exhaust surgeon in 3 different states an on my 4th state I found someone who would take me, keep looking, keep making phone calls....