Insurance and Revision

Ashleigh P.
on 11/19/18 5:21 pm

Hey Everyone,

I wanted to see if anyone else had any experience with this. I was banded in 2010, but had a horrible time with it and eventually had it slip and had an emergency removal in 2014. I opted to not have a revision surgery at the time. Fast forward 4 years and I'm not doing super hot. Put on the weight and more over the past few years thanks to depression and poor choices.

I am looking into getting a VSG done and was wondering if I would have to go through all the prerequisites done, since I have already had a WLS. My current insurance (cigna) is the one who covered my removal.

Since it has been almost 5 years since the removal, would they make me go through the same song and dance as before? Normally I wouldn't have a problem with it, but I am planning a cross country move next July, and if I have to do the 6 month food plan, I would be getting surgery right before my planned move.

I don't want to have to choose between surgery and my move, but if Cigna is going to make me wait another 6 months, I don't think I will have an option.

Anyone get approved for a revision years after being de-banded?

jenorama
on 11/19/18 9:54 pm - CA
RNY on 10/07/13

Everyone's insurance is different--even folks who have the same carrier. Your best bet is to call your provider and get their requirements. I was a bit afraid to call mine almost six years ago, but I did and it was a really good experience. I found out what they covered, what their requirements were and they hooked me up with a representative that checked in with me several times through the process.

One thing to ask is if they have a once in a lifetime clause. I've heard of some that do and it might be best to find that out right away so you can plan for an alternative.

Jen

ladygodiva1228
on 11/20/18 4:45 am - Putnam, CT
Revision on 02/04/15
On November 20, 2018 at 1:21 AM Pacific Time, Ashleigh P. wrote:

Hey Everyone,

I wanted to see if anyone else had any experience with this. I was banded in 2010, but had a horrible time with it and eventually had it slip and had an emergency removal in 2014. I opted to not have a revision surgery at the time. Fast forward 4 years and I'm not doing super hot. Put on the weight and more over the past few years thanks to depression and poor choices.

I am looking into getting a VSG done and was wondering if I would have to go through all the prerequisites done, since I have already had a WLS. My current insurance (cigna) is the one who covered my removal.

Since it has been almost 5 years since the removal, would they make me go through the same song and dance as before? Normally I wouldn't have a problem with it, but I am planning a cross country move next July, and if I have to do the 6 month food plan, I would be getting surgery right before my planned move.

I don't want to have to choose between surgery and my move, but if Cigna is going to make me wait another 6 months, I don't think I will have an option.

Anyone get approved for a revision years after being de-banded?

Your best bet is to call Cigna, but speaking from experience with them when I had my band to bypass revision a few years ago I had to go through all the required testing prior to them approving the revision. I also got denied twice before they finally approved it. Cigna will consider your surgery a revision even though you had your band out years ago.

I also want to make you aware that the sleeve is a great virgin WLS, but when having it done after having the band I have seen many folks have to revise to the bypass due to excessive acid causing GERD/heartburn/reflux. Something you may want to think about.

Good luck.

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

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

    

bethmal
on 11/20/18 5:40 am
RNY on 12/26/17

Hi Ashleigh,

I was a band to bypass revision. I don't have Cigna. My band was removed August of 2017 and my bypass was December of 2017. My insurance required all of the pre-op appointments with classes, nutrition, and the psych consult. I also had to wait 90 days to revise and that had something to do with insurance as well. Your best bet is to call Cigna and see what they require. Good luck with your journey.

You can't measure your achievements with someone else's yardstick!

Revision 12/26/17 Dr. Caitlin Halbert HW 260 SW 248 CW 161

Pre Op diet: 12 M1: 13 M2: 11 M3: 9 M4: 13 M5: 8 M6: 7 M7: 6 M8: 9 M9: 5 M10: 2

Gina 16 Yrs and Still
Hanging In

on 11/20/18 6:16 am - Burleson , TX

ASHLEIGH - Congrats, on being proactive, and taking charge, of your future health!

I 100% agree, with the previous responders. None of us can know what YOUR individual insurance policy will cover - even if we have Cigna OURSELVES - and even if we had a revision, UNDER Cigna - EVERY policy is written differently. As scary as can be, call that number, on the back of your member card...it may not be the exact information you WANT to hear...but, then again, you may get a wonderful, Merry Christmas

On another note...if you DO end up having to wait, and move cross-country, I bet there will be worthy surgeons, wherever you move to!

PLEASE update, after you talk to Cigna, so others can learn..this type question gets asked, pretty often

RNY 4-22-02... HAG=Honest And Genuine

LW: 6lb,10 oz SW:340lb GW:170lb CW:160

I learn something new, EVERY day, from SOME body

crysharris
on 11/23/18 6:04 pm
VSG on 11/20/18

I got a revision with Anthem Blue Cross and they denied my revision. On appeal it was approved but my surgeon still made me go through weigh ins and psych eval and dietician. 6 months between having my band removed and VSG.

I agree with the other responders but I would prepare for the full WLS experience regardless of insurance.

Most Active
My RNY back in 1999
shoppingagainnow · 18 replies · 365 views
Lyrica and Restless Leg Syndrome
ChrisFB · 9 replies · 77 views
Revision Surgery
tbsouthamboy · 9 replies · 158 views
cravings
dreamer1234 · 6 replies · 157 views
Surgery Reversed
Stacy E. · 4 replies · 36 views
MAOI
mumqm · 4 replies · 129 views
Dumb question alert!
Marie M. · 1 replies · 121 views
Friday Motivation! - Believe!
Kathy S. · 0 replies · 38 views
×