neyney75

I am sorry you got denied. I would still try to appeal...also just a thought, most companies have open enrollment starting in November for January 1st. Could it be possible there is a different plan that might be offered by your employer that you could change to? I would contact your HR Rep and maybe see about this. I would still do the removal, especially if you are having issues, then maybe (fingers crossed) you could get the revision through an updated plan??? My employer, or husbands, is with UHC. My lap band was covered with UHC with a different employer. It was very easy, just had to show 5 years of weight and co morbidities if needed, which I had. Was approved the first time, no hoops. No NUT to deal with or anything. I was sure trying to get the revision I was going to run into issues. Still with UHC but with a different employer. But it was approved the first time, still just needed to show the 5 year weight history, co morbidities, etc. Just found out I was approved for removal and to get either the sleeve or RNY. Still not sure which one I am going with, so surgeon advised of both to them. Scheduled for surgery 12/4. I wish everyone could have it that easy. I thought for sure I was going to be rejected. Some how the stars lined up and pushed me through. But I really hope maybe some plan change etc could be done to get you approved for next year? I would not give up hope and really talk to someone in your companies HR to see what is written in for the plan. Like someone else said, each company is different. I used to work for UHC as a rep for the companies, and most don't know that it is their employer that actually sets the plan limits. Some employers are self insured, meaning that all UHC does is manage the plan and your employer pays all the medical cost to a certain point, like hitting max out of pocket, then UCH pays. Then there are other employers that are fully insured, meaning UCH (or any health insurance for that matter) pays all the claims and they have control over what is approved or not. So a lot of it depends on your employer. Wish I could offer more help than that, but hopefully that gives you a little more something to work on. Best of luck to you!!!

Thank you all...I just found out last week my revision was approved by my insurance for either the bypass or sleeve...I have been having some severe intestinal issues and meeting with a gi Friday and see what he recommends...but as of right now I think I am going with the sleeve, unless he strongly suggests otherwise. But another question how is there scar tissue on our stomachs? I did not think the band would do that kind of damage...my surgeon really pushed the bypass and I am just worried if I tell her if the sleeve looks like too much scar from band to do the bypass that she will do it without even looking to see...I know not great to think of my surgeon that way but she is the only one that was willing to fight for me to get the band out. The band did work for me at first I got down to 220 from 310 in less than a year...but then got really depressed and started pushing through the band...got back up to 295 in just a few months =( and since that started working on not doing that and as low as I can get is 275...usually hang around 280...I just keep going back and forth what to do...bypass...sleeve...sleeve...bypass...ugh At least I am approved...surgery scheduled for 12/4 so I have till a week before to figure it out...sigh Thank you ask for listening and understanding what I am going through!

TY =) have you heard of anyone having any hunger triggers from their empty stomach just hanging there? That is one of my big concerns, since your stomach is still there, unattached, but I would have to assume that it still sends the signals it is empty? I like the sleeve for the affect that it removes the hunger trigger. I think all of them can be manipulated. I was told by one of the nurse's that they should never approve the band with people that have PCOS like me, it is no affective at all. She said Sleeve would be good if I don't have reflux, which I don't have on a daily bases but I do have some flares every now and then, maybe a few times a year, so don't really think that will be a big deal. I just don't want to be back in the same boat. I am reading a lot of band to sleeve where some of the weight is coming off but others that it is not. I can't imagine having to do this a 3rd time. I think twice and done, if what ever I choose to have does not work I am done. Ugh decisions decisions decisions!

Hello everyone, I am new here and have some questions about having the revision, for those of you that have had it or are going to. Why did you choice to go with the RNY/Bypass instead of doing the sleeve? (looking at the post size in here vs the sleeve it appears the sleeve is much more popular for revision of band to sleeve, this forum just over 200 posts vs over 1100 in the band to sleeve forum) For those of you post op, with still having the stomach there does it still send off the signals of hunger? If you had to do it over again would you still go with the RNY or would you rethink it? Was it your doctor that pushed the RNY? (Mine would rather do the RNY than the sleeve as feels I will have more success with weight loss with that and reverse my co morbidities right away) Which is another question, as I am reading that the weight loss for some has not been that great, what about curing health, diabetes, high blood pressure, sleep apnea... How long is it taking to reduce them? I was banded in 2009, never really worked, lost some weight but gained most of it back all within the first year of having it. Never thought about having a revision, till my PCP talked to me about it earlier this year. First surgeon I saw would not even think about it as everything appears to be working with my band, no slippage, erosion, band still has Fluid, no leakage found etc... Felt defeated, till talking to my PCP again who was very upset that the surgeon would not even consider it so referred me to another and I was hesitant due to what happen with the first one. Now I wish I had done it sooner, she did not even question it and knew right away what she would say to my insurance to get it approved. Warned me not to get upset if denied at first, that usually happens but she would appeal to get it approved. She said she will do either one, I just have to decided which one. When I started looking into having WLS, when I got my band, I wanted the sleeve at that time and my surgeon vetoed it so I decided to go with the band over the bypass as I really do not want to reroute any of my organs. I just have read a few too many horror stories of complications with the RNY. So that is why I need some help as I am on the fence, I am leaning more to the sleeve, but I don't want to rule out the RNY till I know a little more...which is what brings me here. Any help would be great and thank you for reading...sorry so long.