Insurance Coverage for Revision Surgery

I have a Lap band (9/2007) and am pursuing w's revision.  Would like to go the route of a duodenal switch.  I have new insurance since initial surgery.  My current insurance company will pay for Bariatric surgery, like most others, providing certain criteria has been met.  A question has been raised about one issue of my insurance company's coverage for revisional surgery.  I would like to know if anyone else has encountered this issue.  My insurance company indicates it will pay for only one Bariatric surgery.  Revision surgery is a "two part" surgery - remove the lap band and create the gastric sleeve.  The issue that has been presented is that my ins. co. may be considering revision surgery to be two surgeries.  if this is the case, they will pay for one or the other -removal of the lap band or the duodenal switch.  Has this been an issue for anyone else?  Thanks so much for your feedback....Mary

The only way to find out for sure is to contact your insurance company, they are the only ones who will be able to tell you that. Good luck!

I think the revision should be counted as one procedure - but only your insurance company will know.  If that is the case, I would ask the doc about self-pay for the band removal and get insurance to pay for DS.  He may be able to do it as an add-on procedure.  Anesthesia and hospital charges would all be covered because of the DS procedure.

I have the same issue with my insurance. I have Blue Cross Blue Shield Michigan. i guess i will get my answer in a few weeks. my band was placed in july 2011.

I had to have my band removed knowing I may never get my sleeve before I could go thru the process to get the sleeve.  The same medical need to have the band removed justified my being approved for the sleeve.