Revision and insurance

Can anyone and everyone and everyone give me their experience with having your insurance pay for a revision surgery.  Specifically those with the "one per lifetime" clause. Tips, tricks, any special hoops?  Thanks!!!

yes am interested in this also

I'm going through the same thing.

Have you started the process at Michelle?

im too thin do they fix us. i cant eat never hungry way toooo thin 10yrs out lap rny was 298 now 125 tops on a good day.any help appreciated. seeing doc 4/1/13 anything medically neccisarey is ussualy pd for by ins. like weightloss surgery. im hoping for like a reversal. is this even possible im not good on computer lol obvious good luck to all. i have regrets but what can u do

Nope i sure cant. Let me knowif you figure it out. I have been denied by tricare and dont k now what else to do.

I was denied originally - but it was because they determined I was "non compliant" with the band.  

My tips would be - look up obesity law and see if there are posts there about getting that once per lifetime clause overturned.  

Or, go to Mexico -- Ready4aChange folks are very helpful.

I was banded there and would have been revised there, but my insurance finally relented.

I was denied my revision because they said i was non-compliant with the band.  I then hired Lindstrom Obesity Advocacy and after a year of fighting i was approved.  .

I was denied for revision too.  I had to have all the info submitted showing all the medical problems with the band.  All the test and fills and unfills.  Once I had shown medical need I had to go thru the process like I never had surgery.  I had to have a bmi of 35 and co-morbs also.  Even after I had the verbal appeal and OK to start the process over, I had to make calls as they denied me every step of the way.

Good luck.  Document, document and document.  I had a fill or unfill every month for the last 8 months before I started.  I also started the 6 month supervised diet with my PCP while going thru this which saved time.

 

This is my take, I was banded November 2008 and lost 85 lbs in the first 18 months. After that I was still seeing my PCP for my high blood pressure and she was constantly monitoring my weight, and exercise. So when I started to gain weight, she was also documenting that in my charts. I have gained about 40 lbs back which probably because my band and tubing are no longer connected. My surgeon request medical records for the last 3 years, so my revision was approved in a week. I am getting sleeved on 4/5/13. Documentation is the key.