Working to get RNY Revision
I am in the process of having revision surgery. I had the RNY procedure in 2006 and was very successful for 6 years. I had my second daughter in 2012 and everything went downhill from there. Her delivery and afterward-present has been extremely difficult-stressful-roller coaster-ish. I am 60 pounds overweight and I am seeing my previous surgeon to have my RNY revision. I have re-flux, erosion to my esophagus, and my pouch is extremely dilated. I have completed my EDG, sleep study, and dietitian visit. I have my UGI and PSYCH eval this coming up week. I am just so nervous that my insurance is going to deny it.
Does anyone have experience with Aetna and approval for a revision? I am a teacher and want to have mine done over Christmas break. They surgeons office will be sending my paperwork in the first week of December.
The insurancecompanyitself has nothing to do with whether it is covered or not that is up to your employer and whether they chose to cover bariatric surgery. As long as they have bariatric coverage and you submit the proper documents then they should ok it. That is pretty short time to get the response from the insurance co tho, they could take longer than that, legally they have 30 days to respond so you might want to check with your docs insurance people about it.
Well, I just found out on Tuesday that I have to switch surgeons (insurance thing). The new surgeon is in the same practice, so he may still do the same thing, but the old one was just going to fix my pouch. He said it was growing back to my old stomach, so he was going to re-sect it and make it back to the original "post-RNY" size.
what Hislady said, really insurance has nothing to do with what is covered, see my Aetna at work has the stupid 1 time bariatric surgery per lifetime that is because that is what my employer "bought" it really is your responsibility to know what is in your subscriber agreement, going in for revision surgery without that information is a lamb going into slaughter. I wish you well with your revision
Well, I spoke with them and they said it should be fine! They said, as long as I do all of the pre-op things, it would be fine. I made sure to select the plan that said it covered bariatric surgery. I guess the concern that I have is coming from the doctors office. They're the ones that stated they have a hrd time getting approval for revisions.
