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Self pay then slippage, now what?



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Hi all,

I was banded in November 2007 (self pay), found the sweet spot after two fills, was loving my band, lost 50 pounds in 6 months, then a major slippage. I took 5 colace (stool softener) tabs, they must have stuck together, I then had a violent episode of vomiting, then noticed a slight difference in restriction and over the course of the next month, it became progressively worse until I had to go to ER as I had not been able to get down even a sip of Water and was becoming dangerously dehydrated. The doctor removed the Fluid from the band and immediately the symptoms disappeared. He told me that it was a major slip but that there was the possibility that the stomach may reposition correctly and if it did that he would try to refill the band. He wanted to give it three weeks for the stomach to possibly reposition. Since the visit to ER was considered an emergency then my insurance covered it. I have BCBS Federal but self payed in Germany (where I live but am visiting the states for the summer.) The German Dr. also told me that it is German law that my insurance has to pay if there are any problems after the initial self-pay (has anyone ever heard of this?)

These are my questions:

When I go for the followup to see if we can try the refill, will my insurance now cover this?

If I have to have surgery to reposition the stomach and lapband will my insurance cover it or:

Will they pay only to remove it or:

Will they refuse to even do that, can the band just stay in there forever unused without causing any problems?

Thank you in advance to anyone who may have any information on this rather complex issue.

Sincerely,

Traveler

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I am also self pay. Part of the 16k was also to cover after care, fills, defills, any problems with slippage or erosion. Check the contract you signed in Germany, I think they should correct the slippage.

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Michee, thanks. I hate to admit this but I don't even remember signing a contract. Whatever paperwork I have is in Germany right now and I'm in the states. I did find something on this site referencing that some states require insurance to cover complications regardless if it was a self pay. So at least what the German doctor said does not seem totally out of line, however him telling me this indicates that I should be relying on my insurance and not him for any solutions to complications. In fairness to the Dr. I believe that he did a wonderful job and that this slippage was my fault due to the Colace (if I could only go back in time to that fateful night..........) My life has changed dramatically since the band and I am desperate to keep it, wish me luck and thanks so much for your timely advice!

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