Worried about ins. approval

(deactivated member)
on 10/7/11 10:57 am
I am finally finished with all my preop requirements from the insurance company.  I had the band in in Feb '09 and out in July '11.  I am wanting to revise to the bypass.  My doctor, nurse coordinater, nut and everyone said insurance approval won't be a problem, but I'm still worried.  I have BCBS Federal, which is great insurance.  I was reading their requirements again and am a little confused, so wondering if anyone can tell me what these things mean.

It says:  Diagnosis of morbid obesity (which I have a BMI of 40.6 with sleep apnea) for a period fo two years prior to surgery. 

When I had the band, I did lose about 60 pounds (only because of vomiting up EVERYTHING), so that brought me under the 40 BMI for some time during the last two years.  Of course, after they unfilled me and then removed my band, I have gained it all back.  Is that going to be a problem that I went under the BMI for morbid obesity but only because of problems with the band?  I hope I'm making sense.

Any thoughts are appreciated!!!!
Jody W.
on 10/8/11 2:22 am - Windsor, CT
I think that you will be fine.. I have BCBS as well... and I had a lapband with the same issues as you... I got approved for my DS within a week of all the paperwork being submitted... you have sleep apnea.... so I think you are all set!!

Original LapBand Surgery - 07/26/06- DS Surgery - 08/16/2011
 HW/LW/SW/CW/GW
289/195/277.5/242.5/170
 

Hislady
on 10/8/11 8:33 am - Vancouver, WA
I think they look at revisions with a little different criteria than an original surgery, tho I could be wrong. I was wrong once before, when I got a band!Even if they do deny you can still appeal, appeal, appeal and that often works. As long as your surgeon is willing to go to bat for you, you should be fine. Best of luck to you!!!
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