Change to sleeve after ins. approval for band?

[MrsLD 0]

Hi Everyone,

Sorry if there are other posts about this. I've tried using the search feature but haven't found any similar threads.

Like many others, I was originally set on lap-band surgery. I went to my consultation, the surgeon said I was a good candidate and it looks as though my insurance will be approving the procedure (I have Federal BCBS).

I starting reading more and more stories about complications after lap-band surgery, I really thought hard about all the doctors visits for fills and unfills, and not to mention all the extra expense of it all (time away from work, $ for the appointments, $ for gas, etc.). After researching and talking to more people about VSG, I really think it would be a better option for me.

My question, then, is if I get insurance approval for lap-band surgery, would another request need to be made specifically for the VSG? To complicate it further, the surgeon who was going to do my lap-band doesn't perform VSG so I will have to change surgeons. Has anyone else gone through this? I am curious about the process and all that is involved with switching procedures (and surgeons) after insurance approval.

Thanks!!

~Laura

[MrsLD 0]

I got a confirmation over the phone today that I was approved for the lap-band surgery. Maybe once I get the approval letter I will have a better understanding of whether I can switch to VSG with a new surgeon!

[Eureka-C 20]

My understanding is that you have to have approval for each surgery. Many surgeons just ask for approval on all at the same time (mine did). I was approved for lap-band/RNY and denied VSG, so I appealed. I would visit some seminars and research surgeons.

[Becca 108]

I would at least try and see if you can get the sleeve (speaking from a patient who did not have success with my band and is in the process of revision). Some insurances still consider the sleeve "exploratory" so you need to get a copy of your insurance details for bariatric surgery. Good luck!

[MrsLD 0]

Thanks for the suggestions! Hopefully I will get the official approval letter in the mail soon so I can chat with the other surgeon on Monday!

[msmugsy 0]

I have BCBS California, and I was originally approved for the band. Just like you, I decided to switch to the sleeve after my initial consultation and reading the boards. I asked customer service at BCBS if I needed a different approval, and I was told that WLS is WLS, and the original paperwork would be fine. Since, I have an HMO, but medical group had the final say and after thinking everthing was going smoothly, I found out had to get reapproved for VSG. Then, I was denied for VSG, but my surgeon's office submitted an appeal for me directly to BCBS, and after a few more weeks of waiting, my surgery was approved! I could have saved a month or two if I had straightened out the paperwork sooner, but everything happens for a reason. Hope your approval sails through the process!