INSURANCE/REVISION 1 WLS PER LIFETIME

ANYONE APPROVED FOR REVISION AND THEIR INSURANCE STATED 1 WLS PER LIFETIME . I'M GOING TO TRY AND GET A REVISION BUT MY INSURANCE HAS THAT CLAUSE

My SIL is traveling, but may get a chance to pop in. She had a band years ago that she paid for, and insurance paid something toward taking it out, but she's had several insurances since, and they will not pay for revision because she has had a WLS. She's been fighting them for several years, and it doesn't look good.

Thanks Bearmom

 Get a copy of your rider. I had a revision.  My insurance says 1 per lifetime but its per insurance company. I had the RNY with HealthNet and the Lap Band with Aetna.  They wouldn't pay for the same thing twice.  Mine was approved as a revision, Band over Bypass, and I didn't have to do the psych evaluation, the nutrionist or the 6 mos wait.  Good Luck.

"Bariatric 100% after $750 per confinement copay; deductible waived.....Limited to $20,000 per lifetime, includes National Medical Excellence. Travel and lodging expenses covered separately. Only considered an eligible expense if incurred at an Aetna designated Institute of Quality. Precertification required. The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Expenses for surgeries to remove excess skin resulting from weight loss will be covered up to $15,000 per lifetime."

THANKS BUT I HAVE A SAME INSURANCE I DID WITH THE LAP BAND SO I'M GOING TO GO THRU AND SEE WHAT HAPPENS

 Oh, ok. Then I'd get a copy of the policy and see what the revision requirements are. I mean, if they allow for a revision, ie. medically necessary it negates the 1 per lifetime.

Thanks Heathercross very helpful

Good luck. I fought with my insurance company for a year to cover  a band removal and revision to RNY. After 4 different appeals, insurance agreed to pay for the removal of the band only. Ended up negotiating a self-pay price with the hospital for the RNY. 

Had the same problem. Might look elsewhere for advise.

You're pretty much screwed. Many insurance companies have now added that clause (I suspect b/c of all the money they are paying out from band revisions!).

Please go on the band forum and tell your story. Ppl need to know what the band is REALLY like! Also.........they need to know that THEY can be the ones getting screwed over by that "one WLS per lifetime" stipulation! So please PAY IT FORWARD and inform on the Lap-Band forum to let those that are pre-op know what can happen to them!!!