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Band Slipped - Insurance Denied Coverage



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I realize that I posted this in the wrong section...

help.gif So I have known all along that my health insurance company does not cover lap-banding, or appointments that go along with it, i.e., fills.

I'm sorry to say that I had a slip - and a bad one, this week and ended up in the ER. I was then admitted to the hospital where they did emergency surgery and re-positioned my band back to where it's supposed to be. Thank God everything went great and they didn't have to remove or replace my band, and I was able to come home Friday.

My insurance company has completely denied the claim, and although I realized that this could happen, I do wonder if anyone has had this experience and appealed with any success based on the fact that, while the lap-band itself is an elective surgery, the repositioning was an emergency situation that they might at least cover part of? This also makes me wonder if a person has a tummy-tuck or other cosmetic surgery, do insurance companies also deny any illnesses or issues that arise due to these elective surgeries? Are there additional insurance policies that a person should take out to cover these things?

Finally, has anyone had the band repositioned and paid out of pocket? What was your cost?

Thanks to all for your input. On one hand I accept full responsibility for the surgery and the cost of maintaining it, but on the other hand it infuriates me to no end to know that if I had gone to the ER with a heart attack or diabetes because I was obese they would have covered the claims without a peep. That seems so wrong.

Much success,

Laura

243/145/140

DOB 10/1/05

Dr. Kuri, TJ

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