Question about 1 WLS per lifetime.....

[Teachingmom 3]

Has anybody else ever fought BCBS about 1 WLS per lifetime? Please tell me your experience- bad or good! I need some help in that area. I had the lap band removed (emergency surgery due to erosion). But I want the sleeve (already approved by my dr.) and BCBS has the 1 surgery rule.

[LipstickLady 25,682]

Your company bought the plan that has a one time rule. My BCBS does not. The sleeve was my first surgery but a coworker of my husband's has had both under BCBS.

[ChristineR 128]

Ugh that stinks I have federal BCBS and I honestly have no idea if it's a one WLS rule or not. I was too afraid of the band.

[Teachingmom 3]

Junior guru- yes they do have that rule but I don't know if I'm wasting time by "fighting it." Plus I want to know if the fact that I had to have the band removed because of erosion plays into it. The band really did work for me- I lost down to 150 lbs (at my lowest). But I followed the rules- IT broke down- not me! The guidelines says something about only revision if its "medically necessary." So I want to talk to my dr. About how to go about getting sleeve surgery approved. I'm just looking for support or words of wisdom. Especially people who've dealt with the same or similar circumstances. I have gained about 30 lbs since feb! My diabetes is now up again & I'm back on medicine for that. So it is medically necessary as far as I'm concerned!