Revision to DS - Insurance Exclusion?

Nannette
on 5/9/11 10:45 pm - Toms River, NJ
I am 8 yrs post op and have regained 60-70 pounds in the last four years.  An endoscopy shows that I have an enlarged stoma and pouch, as well as ahiatel hernia.

I have been toying with the idea of looking into a revision to a DS to correct the issues.  On Friday, I saw a NYC doc (Dr Roslin) that said that I definately was a candidate for a DS revision and that he would do it --

Finally, I allowed myself some positive thoughts about going forward -- only to find out today that my employer's medical policy has a bariatric surgery exclusion!  Self--paying would be about $35K -- definately out of my budget!!!

Anybody successfully battle an exclusion?

Nannette
Lap RNY 6/16/03
Revise to DS 8/15/11

Amber L.
on 5/9/11 10:57 pm - Sweden
My understanding is that fighting an exclusion is next to impossible. I couldn't. More and more policies are including "one bariatric surgery per lifetime" clause, as well. If you change policies, make sure you check for both of those exclusions.
Pretty pretty please, don't you ever ever feel like you're less than f*ckin' perfect.
Pink!


levittown_loser
on 5/10/11 12:19 am - Levittown, PA
Exclusions is solid.       Self pay revision is quite expensive.    Wish I had better news.

HW 341/SW 309/CW 169/GW 190   172 lb. loss with my DS -  Subscribe to me on YouTube!
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Jody W.
on 5/10/11 1:35 am - Windsor, CT

I am so sorry to hear about the exclusion.... especially since I went to the educational seminar with DR. Roslin and he seemed as though he only did RNY to DS revisions on special cases.... Is it possible during your next open enrollment period (usually October) you can change your insurance to one that does not have that exclusion..... just another FYI sometimes it is the employer that puts the exclusion in the policy not the insurance company....

Whichever is the case,... I wish you the best of luck!
-Jody

Original LapBand Surgery - 07/26/06- DS Surgery - 08/16/2011
 HW/LW/SW/CW/GW
289/195/277.5/242.5/170
 

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