Band to sleeve question. Please help.

[jennjarrid 14]

Hi. I had the band in January 2010 and lost a significant amount of weight. At that time I was covered under blue shield of California who paid for it. A few years later I switched insurance to anthem blue cross of California. In August 2013 my band slipped and since I wasn't aware of the sleeve at the time I just had it removed and anthem paid for it. A couple years later I have gained quite a bit of weight back and it's a major struggle. Even though it's been almost two years would I be considered a revision/conversion and would anthem pay for it even though original surgery was paid for by different insurance? Thanks in advance

[liannatx 897]

It would probably be best to call them and ask. Mine had a one surgery exclusion, and i chose to self pay for the sleeve. Maybe someone will know, but to be sure it would be better if you asked Anthem.

[hockeyfan7 249]

I agree that you would have to check with them. I have Anthem BCBS and my band to sleeve revision was covered just like my original band was. My surgeon just put on the forms that my band malfunctioned.

[Bndtoslv 292]

I had my band removed separately from my sleeve (band removed in April and will get sleeve at the end of the month). I don't think it was called a revision but my insurance was billed separately for 2 surgeries. Not sure if that helps you but my understanding is that the insurance companies require all of the same pre-op things (supervised diet, psych, etc.) before approval even if it is all done in one surgery.

Edit to say that I also had a different insurance for my band placement in 2007 and my removal and sleeve in 2015. Hope that is helpful. I don't think that they care about this as long as your insurance doesn't have an exclusion. Your surgeon's office will write a history and they will hear about everything and consider it.,

Edited June 16, 2015 by Bndtoslv