Help
hi, I am in need of advice. I had gastric bypass in February 2004. Laparoscopic. Originally weighed 275 and got to 180 (in 2006). Got married, had a baby and gained a lot of weight back. Currently at 245.
Went to see my old bariatric surgeon a few months ago inquiring about a possible revision and he basically told me I will get denied due to my insurance only allowing 1 per lifetime.
I'm so sick od myself and depressed. Anyone know of a way around to get approved for the revision?
Unfortunately if your insurance specifically states one WLS per lifetime and does not cover revisions at all then you would be denied. Have you called your insurance to see what their policy is?
I would have your old surgeon check to see if your pouch and things are still good.
If they are then you need to look at what you are eating and make the change there.
Do you still measure out your food? Do you still eat dense protein first? These things can and will make a big difference in whether or not you can re-lose that weight.
Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150
Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl
I would not go on a surgeon's opinion that your insurance would turn you down. See if you can find a surgeon who supports revisions and start the fight. It may take a while, and will most likely cause nights of stress to fight the battle.. but in the end it was worth it. My insurance also has the poilcy of one surgery per lifetime.. and even though they did not pay for the first one, they said that was the reason. Also it was not a medical necessity. The first surgeon I had that agreed I would benefit from a revision, was not supportive of getting approval from insurance. So I went to another surgeon, after the first denial, that supports revisions strongly and with his help and that of the office staff I was able to get approved anyway. I went from denial, to denial, to peer to peer meeting, to the insurance medical review board over the period of 5 months but in the end I won!
