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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