One WLS per lifetime....

[Teachingmom 3]

Has anyone been turned down with that reason? I have BCBS OF AL. I had to have lap band removed due to erosion & making a hole in my stomach. Already even approved by surgeon for sleeve. So I'm gonna have to appeal initial reply of denial due to one WLS per lifetime. This is medically necessary due to BMI, uncontrolled diabetes. I'm anxious to hear any similar stories: success or otherwise.....

[Catherine707 253]

That seem a bit unreasonable on the part of the insurance company due to the fact that you had COMPLICATIONS from the first surgery and need the second surgery to do the job correctly! Have they provided you with this restriction in writing? Do you see it in the insurance plan documents?

[kyleebean 209]

I had this happen and then insurance said they would pay for the revision~ part of it~

I agreed to pay for the lap band removal and they paid for the sleeve. However, what they neglected to tell me and to coordinator of the clinic I went to was that there is a 25,000 cap on this benefit. I had some complications and had a 4 day hospital stay to the tune of 130,000. It has been an insurance nightmare ever since.

[kyleebean 209]

Just wanted to add that my lapband caused esophageal dilation and dismotility and I had an infection on my stomach where the lap band was placed.....