Will insurance pay for my revision?

Softballgal73
on 6/23/16 7:40 am

I am 4 1/2 years post op with my sleeve. I have been through pure hell with GERD the entire time. I don't just have acid, I have vomit sit at back of my throat after I eat. I have dealt with this too long and worry about the damage I've allowed to be done. I finally made appt to go back to my surgeon. Insurance did pay for my first surgery, will they pay for a second one if it is deemed medically necessary? I have Aetna and BCBS.

 

ladygodiva1228
on 6/23/16 9:03 am - Putnam, CT
Revision on 02/04/15

If your plan for medical coverage states revisions then yes, if it states one time only WLS then no they will not.  It would be best to give them a call and ask what is and what is not covered under the plan you have.   Some plans cover revisions and some do not even if it is medically necessary.

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

stacyrg
on 6/23/16 3:11 pm
VSG on 05/12/14

I agree that it depends on the coverage provided under your specific plan, but I have Aetna PPO and they are covering my revision from VSG to RNY because of severe GERD.  It was approved quickly and without a fight.  I'm scheduled for surgery on 7/1.

        

Phatchick
on 6/25/16 5:17 am - Brookfield, IL
VSG on 04/16/12

I am in the same boat.......GERD/reflux is so bad. I am 4 years post op from the Sleeve. My surgeon said its a hiatal hernia and he said fixing the hernia is useless with the sleeve and wants to do RNY since I still have 75 more pounds to lose. I have Humana PPO and worry I'll have issues with insurance as well. Good luck! Hugs!

  

 

    

    
JaxLiving
on 7/7/16 5:39 am - Spanish Fort, AL
RNY on 05/27/16

I had the lap band in 2010, and my Blue Cross policy said only one WLS per lifetime -- even if it was deemed medically necessary. I opted for self-pay. Although I didn't go this route, my physician's office offers a financing plan through an outside company. You might want to look into that if your insurance doesn't cover the revision. I had RNY on May 27, and I would do it again in a heart-beat! I know, without a doubt, that I made the right decision! It's an investment in your future!!!

SW:223, CW: 134.2; GW: 125, RNY: 5/27/16

MuttLover
on 7/9/16 6:48 am
VSG on 11/14/12

Here's the scoop -- your revision is NOT  really a bariatric procedure -- it is a REFLUX procedure.  Talk to your surgeon about your options and how it is submitted to your insurance company -- but different rules apply when RNY is being done to address reflux than when it is a primary bariatric procedure.

Also I expect you'd need an upper GI or other contrast test to see if you have a hernia or other underlying condition.  If so, again, your RNY would be primarily to address those issues.  

Unfortunately, I know this from experience!  I am 3 months out from my revision to RNY because of a paraesphogeal hernia and reflux.

 

  

Starting weight: 260; Surgery Weight: 250; Month 1: -15.6; Month 2: -11.8; Month 3: -11.4;  Month 4: -7.4  Month 5: -8.6; Month 6: -3; Month 7 -3.8; Month 8 -7; Month 9: stall; Month 10: -4.4; Month 11: - 2.6; Month 12:-3.4

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