Question about Insurance

Shanae1
on 4/17/12 10:06 am - Marana, AZ
VSG on 03/21/14
Hi everyone,

I have a question about Insurance. I have Blue Cross Blue Shield of Kansas City MO and I had a lapband put in 2 years ago on July 22 2010. Due to complications I had it taken out with emergency surgery last year in June 2011. I would like to get the sleeve now that I am back and healthy but I called my insurance today and they told me that I have a $20,000 lifetime limit. I'm sure most of that is used up now because I had fills and all of that. Has anyone else had to go through them or the same situation to get a revision? $20,000 just doesn't seem like enough!  

My plan is to go through with the bariatric doctor and just try to get approved, and I am ready to put up a fight if they do deny me. but I may have no chance at all if they stand firm to 20,000 dollar limit. I wish I would have kept my band in and then tried to get a revision but I was too sick to not get it taken out then.

Any advice or help would be great!

Thanks,
Shanae
Hislady
on 4/17/12 4:00 pm - Vancouver, WA
Just be thankful you got that thing out of you and lived to tell about it!!! If your insurance has a limit there is really little you can do to get them to change it. I'm sorry to say you are most likely among the hundreds of other bandsters who have been dealt the same unfair hand. Non of us knew what a horrid product the band was and now we are being penalized by the insurance companies who are now setting limits or limiting it to 1 WLS per lifetime. Probably the only way to get a revision is to selfpay. It's not fair but the insurance co.s really don't care. If they have a limit even appealing won't probably help. I wish you the best of luck but don't be surprised if you don't get anywhere.
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