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Harvard Pilgrim??

By k_podski, August 6, 2010 in Insurance & Financing

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k_podski 2

Posted August 6, 2010

Hi all, I cannot find any info on this site of anyone dealing with Harvard Pilgrim for this surgery, more specifically a band to sleeve revision.. My surgeon has approved me for this revision and said he is willing to help me fight to get it. I am no stranger to this site as I followed it over from lapbandtalk.com when I saw how many people were getting revisions and having beter success. The hunger with the band is killing me, and the constant fill/ unfill process is getting old. I am over the extremes of starving or sliming.. And always feeling hungry.. My doc feels as though the sleeve would be a better choice to address the hunger issues. I have lost 50lbs with the band since 3/19/08 (246lbs-195) and have maintained, which is considered average- but the surgeon thinks I could stand to lose another 50-60lbs.. At 5' 3.5", my personal goal is another 50, anything extra would be a bonus!

Supposedly Harvard Pilgrim is one of the top insurance carriers now adays, and have always been great to deal with, and quick with descisions. The doc wants me back in 2 months to see what progress he's made with HP and for me to see the nutritionist every 2 weeks until then and get a print out from my gym of my visit dates to show a paper trail to help my case. He feels as though the sleeve will be the new band and that the band is already phasing out due to complications and lack of success. He also feels that now there is 5 year research out on the sleeve that more insurance company's will cover the surgery.

As of now HarvardPilgrim.com states that it does not cover the sleeve, however when I called to inquire if I could get around it they suggested my surgeon call with more info and codes..

Any ideas or experiences with Harvard Pilgrim?

Thanks in advance for any input,

Kerri:)

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