Question:
Has anyone had insurance pay for revision? How do you qualify, how much weight gain?

   — peggy B. (posted on October 3, 2003)

October 3, 2003
Hi Peggy: I'm sorry no one has answered your question yet. I'd be interested in knowing the answer from someone who knew for sure too. I would say that if it's medically necessary the insurance should pay for it, and you shouldn't need to gain weight to qualify. I would think the qualification would be a surgical failure? Not sure though. If you find out for sure let me know. Thanks, Sherry
   — sherry hedgecock

October 3, 2003
My SLD was covered. It was written up in such a way that the docs made it very clear that there WAS a SLD and the following WOULD happen: regain had begun, reflux, back to treating full and constant ulcers, soon the list would get bigger, sleep apnea, asthma, high BP, high cholesterol, etc. Guy says, "is this just a repair, like fixing a flat tire?" and I said yes. Poof, done deal. They didnn't make me gain more wt than I had (12#) as they didn't want to go all those comorbs road. I was nice, healed on schedled , had no pros, caused no prob. A non=event, as my doc would say
   — vitalady

October 6, 2003
My insurance paid for my revision from VBG to RNY. I had a SLD at around 5 years post op of the VBG. I did gain most of my weight back, but that was because I didn't even know a revision was possible. I am sure it depends on your insurance company as to whether you have to have a certain BMI or show proof your co-morbids are back.
   — Ali M

Click Here to Return