Did BCBS Federal cover your revision?

Virgie Tschirhart
on 8/29/14 7:38 am, edited 9/10/14 10:45 am - Midwest City, OK
RNY on 12/27/17

Hi ,  it's been awhile since I've visited.  I want to get my Sleeve revised to the RNY.  I have horrible acid reflux and a huge Hiatal Hernia.  Ok this is going to be my 3rd WLS.  2008 LB lost 17 lbs and gained 20 lbs.  2009 VSG had worse acid reflux then with the LB.  Lost 30 lbs and gained 20 lbs.  Never got to my goal.  I was hungry all the time.  I  really did not do good.  I need the malabsorption.  Anyway,  I have BCBS Federal.  They denied me last year.  This time my doctor is going to say this is Medical Necessity.   Thanks for your help. 

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

Epthomas59
on 9/1/14 11:34 pm

I have BCBS Federal and I had no problems with my approval. It happened rather quickly. I had my surgery on 20 May and am down 47 pounds as of 1 September.

Virgie Tschirhart
on 9/2/14 11:53 am - Midwest City, OK
RNY on 12/27/17

HI EPTHOMAS59,  THANKS SO MUCH FOR YOUR REPLY!!!  What state do you live in?  I live in Oklahoma even though my insurance is BCBS Federal, I work for the government.  CONGRATS on your revision surgery!!!  47 lbs lost, you are doing great!!!  I guess you did not have to do a 3 month program with a nutritionist and exercise program?  That is what I'm doing right now.  

Thanks so much for your reply.  

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

wdufford
on 4/27/16 3:29 pm - Mount Pleasant, SC

Hi.  I saw your post - did BCBS Federal cover your revision or were you talking about the initial WLS?  I'm hoping to get a revision but worried about BCBS coverage.  Did you have to gain all of the weight & get back to where you were before they would pay for the revision?  Any advice would be great.  Thanks.

Epthomas59
on 4/27/16 3:48 pm

Yes it was covered with no problem and it was a revision. My original surgery was not correctly,

airbender
on 9/9/14 12:29 pm

it is not "which insurance company is best as far as approving your revision" but you individual policy.  your employer picks what is and isn't covered we could have the same insurance carrier with vastly different policies, you have to read your subscriber agreement and pay attention to what is covered, and exclusions

Virgie Tschirhart
on 9/10/14 10:40 am, edited 9/10/14 10:46 am - Midwest City, OK
RNY on 12/27/17
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