Did your insurance cover your 3rd weight loss surgery?

Some of you are familiar with my story.  

2008 - Lap Band - Did not find sweet spot, gained back my weight.  Had a Hiatal Hernia with acid reflux.  BCBS Federal did approve this surgery.  Dr. Timothy Eldridge

2009 - Removal of LB and revision to a different bariatric surgery VSG.  -  Did not reach my weight loss goal.  Hiatal Hernia has enlarged and acid reflux worse.  BCBS Federal did approve the Removal of the LB, but Denied the VSG, had pay cash.  Dr Toby Broussard 

2013 - Was denied for Revision to a different bariatric surgery (RNY) - Because of not being in compliance with the 2 previous surgeries.  Dr. Luis Gorospe

2014 -  Planning on Revision to different bariatric surgery (RNY).  On my 3 month program right now.  Dr. Lana Nelson

Anyone out there having a 3rd chance of surgery covered from BCBS Federal or whoever?  Yes, I checked read and understood BCBS Federal medical policy and they do cover revision to different bariatric surgery.   

Please share your story.  Thanks everyone!

Babygirlinokc

the question is not which insurance company will cover surgery as all will if deemed medically necessary, the question is not how many surgeries you have had either will not pay, it really is that simple.   I dont see anything in your post about your reasons that you had for conversions and you are asking for conversion #3 with no mechanical failure if I understand correctly?  This will be a very hard sell, even for an attorney, hope you find answers real soon

I Cant get approval for a revision thru tricare. I am at a dead end. I've gained all my weight back plus some.

I was denied because after my lap band surgery I lost am amount below thier standards. What I dont understand is why thet care. They didnt pay for my first surgery.

the question is not which insurance company will cover surgery as all will if deemed medically necessary, the question is not how many surgeries you have had either will not pay, it really is that simple. I dont see anything in your post about your reasons that you had for conversions and you are asking for conversion #3 with no mechanical failure if I understand correctly? This will be a very hard sell, even for an attorney, hope you find answers real soon

Hi airbender, I know it's been about 3 years since I've been here. Sorry for the late response.

My Reasons for the conversion of the Lap Band to the VSG:

1) I did not get the results I thought I should have. I lost weight about 20 lbs and then gained it back. Kept throwing up my food and could not get a sweet spot on the level of fills.

2) Acid Reflux was getting worse. BCBS Federal did cover the LB.

My Reasons for the conversion of the VSG to the RNY:

1) My Haital Hernia has become severe with Acid Reflux just about every night with coughing and burning sensation that lasts for hours. It has become worse and has made me even more depressed.

2) Need to lose weight with the Gold Standard Surgery (RNY). I have High Blood Pressure, Type II Diabetes, I am 5'1" and 190 lbs. I have Heart Attacks and Strokes in my family history. BCBS Federal did NOT cover the VSG, I did Self-Pay for the removal of the LB and the VSG.

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