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Does Medicare or Medicaid Cover Revision Surgery?

Amy B.
on 3/30/12 9:23 pm - Oak Grove, MO
Hi everyone I'm Amy and I had a gastric bypass in 2004. I was 315lbs before surgery and two years later I was down to 160lbs. Well I maintained that weight til 2007 when my mom passed away. Soon after my mother's death I started gaining the weight back. I feel hungry all the time like my stomache is always empty. I eat constantly and now I weigh 225lbs. and I feel like such a failure. Then I saw the revision surgery and thought that I might be a canidate for that. Does anyone know if medicare or medicaid will pay for revision? They paid for my RYN with no difficulty. Does the revision really work? I Need HELP PLEASE!!
Ladytazz
on 3/30/12 11:33 pm
Medicare paid for mine.  Not too sure of the qualifications.  I was over 35 BMI with several comorbidities and other diagnoses.
My feelings about revisions are that I never would have had one just for regain.  I had my revision because of ongoing issues I had from the first WLS.  I actually wanted a reversal but I was told that my surgery couldn't be reversed, only revised to have less malabsorption.  My stomach was made into a RNY pouch because I was afraid of gaining even more weight.  I was told not to expect to lose weight.
A revision can work if you have confronted the problems that caused the original surgery to fail.  For me it was out of control carb addiction.  I had to be honest with myself and commit myself to avoiding refined carbs, especially sugar and wheat.  To this day, over 20 months later, I have not gone back to them.  I am sugar free and gluten free.  I decided when I had my revision that I had a second chance and I wasn't going to make the same mistakes as I did the first time.
The first thing to do is see your surgeon and find out if your original surgery is intact or if your pouch or stoma has enlarged.  If they haven't then you still have your tool and you can choose to use it.
You choices for revision are to have the RNY redone, to have a lap band placed, or to have a DS.  Many people revise to the DS because it has a better track record for losing weight and keeping it off, as well as resolving comorbidities.  It is a very difficult surgery and there are only a handful of surgeons who are skilled at doing it.  Check out the DS forum here or go to dsfacts.com to find out more.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 110.

D. Switcher
on 9/13/13 1:13 pm

Hi Amy, how have things worked out for you? rdc

 Sleeve to DS Conversion - Regain 290# Current weight: 252# - VSG lowest weight: 235#  

"Serenity to Accept, Courage to Change, and Wisdom to Know..."

***all comments are my personal experience and/ or opinion***