Bad Choice?

Sterbear · March 12, 2008

I decided to go to Mexico and get my band placed because insurance here denied me. However, I think my band has slipped. Every time I have anything filled in my band, I end up in the hospital because my band completely shuts up and I end up not able to swallow anything. (even my spit comes back up) I went through this routine 3 times and the last time I was throwing up blood, which scared me. I am completely unfilled now. Will insurance now pay for my band to be fixed in the U.S.? Will they pay for me to get it looked at at least to find out what is wrong? I have lost 60 pounds and it is slowly coming back and that scares me too! I feel like I made a dumb choice in going to Mexico because I am now staying at home with my daughter and do not have the money to go back to Mexico. Anyone know if insurance will help?

Daisalana · March 12, 2008

Call your insurance and ask! That's the best solution.

My insurance said (I gave them the scenerio that if it's going to kill me, shouldn't they do what they can to keep me alive?) that no matter what, they will not pay for anything to 'fix' something I did to myself that they don't cover.

Meanwhile, get to a doctor that can do a fleuro and check if you're slipped or eroded.

Since my insurance won't cover things band related, they have paid for my fluero and emergency ER visit depending on what the people write it up as. The ER visit was fear I had blood clots (as a result of surgery), but they paid for it since it didn't say the surgery. 2 fluero's have been covered for me, they didn't list that it was for the band. 2 were listed as band adjustments and insurance denied them.

Marimaru · March 12, 2008

It probably depends on why you were denied. If you were denied because they don't handle weight loss surgery what-so-ever, probably they will not help you. It shouldn't cost more than a couple hundred dollars to at least find out the status of your band. I was quoted $175 for a flouro with an office out here, just to check it's position. Whoever is doing your fills should have access to something like that.

My understanding is that insurance wont cover anything unless it's deemed a medical emergency for it to be removed, and then it's because it's billed as "emergency surgery" not "lap band removal". I was banded in Mexico because I didn't have any insurance at the time. I'm still waiting to find out if the insurance I've gotten since then will cover anything.

Elisabethsew · March 12, 2008

You really need to call your insurance company and check with them. Normally, insurance carriers will not pay for complications related to a procedure that they did not cover but it all depends on the diagnosis and treatment plan.