Has anyone had revision surgery thru tricare?

I had my initial gastic pass by in March 2000 and had complications with bleeding where I had to have several blood transfusions. They never did find the cause of my bleeding. Ten years later i started to gain the weight back and no mastter what I tried I wasn't bale to lose. I went to another gastric surgery who said he could see where they had made mistakes with my surgery and I could benefit from revision surgery and we were all set to have the surgery. However, I have Tricare  as my insurance and they only pay for one surgery per lifetime. I wondered if anyone on here has had revision surgery thru tricare where they paid for both you initial and revision surgery and if so you can share with me how you got them to approve this.  I would great appreciate this.  Thanks so much.

Dot.

I haven't dealt with them myself but I would appeal it because you aren't having a weight loss surgery you are having a repair to an existing surgery that was done incorrectly the first time. Most insurance will pay for a repair to an existing surgery maybe your surgeon used an incorrect code number for an original surgery not a revision, I believe they have a different code number. I wish you well talk to your surgeon and see if there is a different code or ask for a peer to peer meeting between your doc and the insurance co. that often works when the surgeon can actually explain the surgery.

Dot, I  had the original (2002) out of network, so they did not cover all. But the revision, yes I finally got approved and surgery was last Monday. It was a VERY hard long battle. The key factor for me being approved were two fold. One I had a team of people from the surgeons side who worked hard, but more importantly, I did not give up.. I refused to.. I was denied, denied again, denied at a peer to peer review then had to wait (due to their screw ups (and quite intentional ones I believe) )30 days for the medical review board to decide if they would overrule or accept the decision the peer to peer group had decided. It was overturned and I have had my surgery. By that time, Tricare knew I was not going to let it go.. I actually had their phone number in my contacts I called so much. One thing to mention.. for me, my surgical team was a pro at dealing with Tricare.. they knew what to say and how to say it to get through the system.. in the end it was not only approved, but approved with little medical back up provided by the surgeon on my part as to the reasons I needed it. 
So yes, it can be done.. but not quickly and not without a excellent team including the surgeon behind it, and a LOT of persistence on your part. 

Thank you so much for sharing your story with me. Can I ask where did you have your revision? What type did you have?  I don't plan to let this go this time. The denied me the first time saying it was my fault I gained it back. But what I don't get is they are paying for revisions for lap bands right and left b/c they erude but they do that b/c they eat things they aren't supposed to!!!  I would love to learn more could you email me at [email protected] or if you are on facebook messenage me i'm under dot hochstrasser

A million thanks

Just an FYI, when the lap band erodes it has to be removed it is a matter or life or death because when it erodes it leaves a hole iun the stomach and that can't be left that way with stomach acid draining into the stomach area, it would eat up other organs. Erosion is not from eating things they aren't supposed to, that has absolutely nothing to do with erosion. They erodes because of scar tissue growing around and between the stomach and the band. Also often they may remove the band but not cover another surgery, like I said it is life threatening so the have to come out but the don't often get another surgery when it is removed. I know hundreds of people who are banded and can't for the life of them get their bands our and are just sitting there with time bombs in their stomachs and scared to death they will be the next one in the emergency room for removal surgery and end up having to pay the bill. I had to pay to get mine out because I simply could not live with the pain the band causes. I wish you well and hope you will succeed in the end, keep after them!

Tricare does not pay for lapband revisions to sleeve ( well denied me twice, maybe if I would have fought harder) I am sure there are exceptions, but don't think it is common. I was told they will consider RNY because they cover that but they also now have on their website the exclusion of one surgery per lifetime and they paid for my band. 

They did pay for the removal because it was medically necessary it slipped, had hernia and my esophagus was dilated (and not because I did anything or ate anything wrong) I was very successful lost 90 pounds and kept it off for five years and only gained because I had no restriction. I had to be self pay for the sleeve (7/8/15).

Now maybe they would have paid if I fought harder but I couldn't wait to have the band removed and didn't want two surgeries. So had to beg and borrow for the sleeve