Getting insurance approval?

I was denied 7 years ago for RnY. Paid for my own lap band out of fear going to Mexico. I want to revise my band to RnY. Have an appointment Wednesday.

PROBLEM: I do not have HTN, DM, High cholestorol (got it down), and probably no sleep apnea.

I have pretty moderate and becoming severe mobility issues from neurological deficits in left foot and back causing too much weight bearing on the right foot which needs surgery because of ankle instability, bone spur, and plantar fasciitis which I have been dealing with since March.

Also moderate constant pain in my neck and back after an MVA in 2005 that caused the herniated disc and the problems. I have to do the assisted diet for 6 months.

ANY ADVICE - for getting approved. I will appeal a denial this time. I need this or I'll be truly disabled soon. I weigh 260 - my band is a joke. I suffer from dysphagia, fills only make it worse and I have basically no restriction. I want this thing out - waste of $9000. The Doc told me at the seminar that I am a perfect example of why he rarely does the band.

I am sorry if  I missed this in your post, but what insurance carrier do you have?

 Definitely try for approval, and definitely appeal if you're denied.  Unless your policy states that it doesn't cover bariatric procedures, you have a chance.  If there is an exclusion, it's probably not worth your time.

I did have high blood pressure.  I also listed migraines and stress incontinence as co-morbids.  They can't tell if you have stress incontinence or not....  list anything you can possibly connect to weight.  

Good luck,
Laura

I have Buckeye health insurance and they do approve them with comorbidities. I am also 5 foot 1. BMI in the upper 50s. I have had a headache for 7 years and some stress incontinence at times. I listed a lot of health problems on my info the summa weight loss surgeons. They have a great program. Losing weight would take a lot of pressure off of my back and neck and also off of my feet and ankles. It would improve my ability to exercise and reduce my high risk for having the major co morbidities that are going to come from losing mobility. Thank you for any advice!

You might want to ask your doc about having a sleep study done to check for sleep apnea.  It's pretty common and most people don't realize they have it.  Do you have more than 100 lbs to lose?  If so your insurance will probably approve even without a whole lot of comorbidities.  It never hurts to try!

All insurers are different. I have Cigna. With your BMI, they would not require that you have comorbidities. They do if your BMI is 36 or less. I found Cigna's requirements online. You should look up Buckeye's.

thank you Jewell, Kat, and Laura. Buckeye does not say their requirements but says it pays if medically necessary. Also I was reading my profile from years ago where I wrote that I had mild sleep apnea. I remember it was barely on the mild scale - forgot about that. I am going to fight if denied and also get letters from my podiatrist and family doctor. trying to get into the pain clinic for cortisone shots so that would also be evidence of weight exacerbating medical conditions. I am going to try really hard. The only way to reverse some of these problems is to lose a lot of weight and keep it off.