Hoops for revision too?

leanner977
on 11/20/12 6:33 am - Hobart, IN
I had RNY in April 2006 at 285lbs. By August 2007 I was at 175, that was the lowest I got and as of today I'm back to 256. My doctor referred me to the bariatric guy (I have changed insurance and employers since my original surgery) and ordered an upper GI. I'm just wondering if I'll have to go through all the hoops (6 months of monitored dieting, psych consults etc) to have a revision or band over bypass. I currently have UMR but I couldn't find revision rules on their site.

Leann ~~~ My WLS site


tattoobabe
on 11/20/12 8:48 am - MI

It really depends on your insurance. You should contact them and find out first if they cover repeat bariatric surgery and if they do what are the requirements to be approved for surgery. Some insurances do require proof of you being on a supervised diet..

pineview01
on 11/20/12 11:35 am, edited 11/20/12 11:36 am - Davison, MI

Yep, up to your insurance.  I had to go thru more hoops to get the revision approved than the original.

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

smileyjamie72
on 11/21/12 4:26 am - Palmer, AK

Do you have an actual paper copy of your policy?  If I were you, I would at least make an appointment with your PCP and discuss the possibility of a supervised diet, that way, while you get the answers you need, you are "getting your ducks in a row".  It sucks, but the hoops are a part of the insurance "game".

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003  
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

 

 

 


 

 

 

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

leanner977
on 11/21/12 4:53 am - Hobart, IN
I hate talking to my insurance company about anything, I feel like I get no where. I suppose the staff of the bariatric guy I'll be seeing "for follow up from RNY 6 years ago" (as my PCP wrote on the referral) will know the rules.

I was just looking for the experience everyone else had knowing it varies from one company to the next.

Leann ~~~ My WLS site


airbender
on 11/25/12 2:49 am

there are countless numbers of different insurance policies out there.  i wouldn't take the word of the "bariatric guy" or any other guy, the experience they have is general and not specific to your personal plan as it is your employer who decides what they want to "buy" in the insurance policy, it is your responsibility, call your insurance co ask for the subscriber agreement, not the summary of benefits, in the subscriber agreement everything is spelled out for you...good luck with your future revision

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