Insurance question, has anyone hears this?

I called my insurance and was told revisions are only allowed if a medical necessity. I didn't lose enough weight and I'm almost two years out.  I am interested in getting my sleeve checked out to rule our mechanical failure.

I'm curious to know if anyone was successful with getting their second surgery covered even after hearing this? 

i know that if your BMI is above 40 then it would be "medically necessary" to do the other half of the DS if that is what you wanted done

I am 5 years out from a sleeve.  I have gained every ounce back.  I didn't lose all I needed to.  I called my surgeon's office and was told there are no revisions for a sleeve.  Is that right?  

TOTALLY not true! I suspect the truth is that your particular surgeon can't do a revision on a Sleeve, but there are docs you can and do. The most logical revision would be to add the Swicth, the intestinal portion of the DS. (The Sleeve is the stomach portion of the DS anyway.) The DS has the very best long-term, maintained weight-loss stats, period. It's also the best at resolving or preventing things like diabetes and high cholesterol.

Thank you so much.  I am finding out now that he doesn't do the revision.  His people told me Medicare doesn't pay for any revisions.  Well, I researched it an they do.  I called another doctor in the same hospital and suddenly I got a call from my original doctor's office and he wants to see me for "nutritional counseling".  Hmmmm. I have been able to eat as large a portion as I wanted since my sleeve.  The sleeve wasn't what I went in to surgery thinking I would get.  I was supposed to get the bypass.  He said I had too much scar tissue to do that.  Others who went to Dr. Barker in Dallas have told me that he removed all the scar tissue/adhesions during their surgery.  I am so confused!

I start the process all over this week. I'm ten/twelve pounds off from 40 BMI. Ugh 

Medically necessary can also be bmi 35 with co-morbs.  When I was unbanded and working to get the sleeve I started at bmi of less than 35 and it had to be 35 with my high bp and a thickening heart valve.

not sure what you mean by this post?  unless you have a cosmetic rider on your insurance, insurance doesn't pay for procedures that are not medically necessary.  you should be able to have your sleeve checked if you have issues, not sure what mechanical failures you anticipate to find, medical issues you have, how you are feeling etc, but have it checked out to rule out problems....

Who are you talking to?

She is posting a reply to the original poster's ( HKFandoea's) question.  Jody you should have made your first post a new thread instead of piggy backing it onto this one as it makes it confusing to follow.  Than those looking could find you easier too.