Question:
Does Insurance cover a second weight loss surgery?
Gastric Bypass was Nov 1999, I am gaining weight!! I need a DR in Alabama that does second surgeries and pray insurance will cover it or part of it! HELP!!! — Tammlin (posted on April 9, 2009)
April 8, 2009
Hey Tammy, I know that you might be putting weight on but the first surgery
should still be doing its job. This wls was meant to only help you lose the
weight it is a tool. If you try going back to the basics it might help.
Sorry that might not answer your question, but if you lost the weight once
you should be able to do it again. You just might have to use some more
elbow grease to get the job done this time. Best of luck.
— trinity P.
April 8, 2009
Sometimes to will cover a revision. It all depends on your insurance
company. However, try going back to square one for a little while and see
if that will help before a second surgery. I had a Lap Band in 2001 but
had to have it removed in 2002 due to slippage. My insurance (at that
time) covered the placing of the band, but I had changed insurance carriers
when the band slipped so it didn't cover the removal of it. Now I just had
another band placed yesterday and my insurance is covering the second one.
If you do find a doctor that will do a second surgery, he or she will
probably code it as a "mechanical complication or failure". Then
your insurance might be more likely to cover a second procedure. I work in
the medical insurance industry as a claims analyst and if I have learned
one thing, it is all in the wording of the physician and they can usually
figure out a way to get the patient's insurance to cooperate. Especially
if they have been doing that specialty for a long time. :-)
As far as doctors in AL, I am no help there. I had a great surgeon in
Texas and now another great surgeon in SD. Good luck and keep us
posted!!!
Beth
— Elizabeth K.
April 9, 2009
Mine did. BCBS of California. I had the lapband and was revised to RNY and
they covered both (withOUT a fight either :) How about the Stomaphx or
Stopamax (spelling of each?)
— Cathy A.
April 10, 2009
With an old surgery like yours, it's very likely. I had good insurance
only in 1994 and again in 1999-2004 when I had to revise. The rest of the
time, WLS has been an exclusion. I'm WA state where insurance is kinda
hard to get with WLS coverage. When it was stated as a repair to my 1994
original, it flew right thru.
— vitalady
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