I'm stuck with my band until it erodes

[RAAinNH 113]

Last February, I received pre-approval from my insurance company to have revision surgery from the Lapband to the Sleeve. Yesterday, after completing the required Bariatric Program and receiving a surgery date of June 25th I was informed that my insurance company will only pay for the Lapband removal but not the Sleeve. Their reason is that the lapband is not eroded. Still, they are willing to cover the removal but not the revision to the Sleeve... it doesn't make sense. Why cover one but not the other? Or if they feel the Lapband has not failed, why not refuse the removal? My Surgeon has set up an appeal with my insurance company. I am trying to be optimistic but it feels like a long shot.

I've had my Lapband for three and a half years. I managed to lose 30 lbs only to gain it all back. I felt foolish and stopped going to the first Bariatric Center where the Lap band was done. Long story short...I did not feel supported there, I felt judged, ashamed & embarrassed.

In February, enrolled in another Bariatric Center and have faithfully followed their program. I have taken off 20 lbs but it is hard to maintain. Today is the day I was to start my pre-op diet. I will not have the band removal only surgery.... if I do, I fear that I will never get approval for the Sleeve. I have little restriction and a whole lot of reflux. It's not an option for me to get another fill as it will make the reflux even worse.

I feel that I was lied to by the manufactures of the Lapband. I was never informed that the band scars the stomach and sometimes attaches to other organs. They made it sound like it was easy to remove when in reality, it has to be cut out. They never mentioned the high instance of slippage and erosion. Constant heartburn and acid reflux is what I have been dealing with for the last two years. Medications help some but I have frequent break through heartburn that often keeps me up at night. I used to think it was hunger and would eat to get rid of the sourness and burning feeling in my throat and sometimes chest. I was later informed by my doctor that it was actually acid reflux not hunger.

Now that the shock of the denial has worn off and I stopped crying and feeling sorry for myself. I am going to fight this... fight the insurance company. I will continue with my weight loss efforts, eating right and exercising. I am hoping that the Bariatric Center will keep me as a patient, monitor my progress and help with appeals to the insurance company. I will keep applying for the revision until it happens.

[Ms.AntiBand 2,984]

Absolutely .. And fight hard. Insurance companies want you to give up so they don't have to pay.

[SerendipityHappens 1,594]

Hopefully you will be able to get the revision you need. There are many here for whom the band did not work. There is no need to be embarrassed. When I was in Mexico for my sleeve there were several others were doing or had done Band to sleeve revision. Thank you for sharing your story. I considered the band several years ago because it seemed like such a miracle device. Thankfully after reading stories like yours I opted not to do it. So I hope you continue to share your story because people have the right to this information. Best of luck to you, I hope you will find resolution to your problem soon.

[Iniysa 157]

Keep fighting it! Good luck!

[chinamama 104]

Call lindstrom law offices, they were not as expensive as I thought they would be. They even advised me to do the peer to peer before hiring them. We did the peer to peer and was accepted so never had to hire them, but.....

[christina0613 103]

Its not so much the manufacturer who didn't tell you about slipping and erosion it was your surgeon. .I was told that n did research n knew if I was gonna have surgery it was going to be once..the band in a lot of surgeons veiw is for people who only need to loss a low amount of weight..I had the sleeve..I would fight with you insurance n maybe point out that your 1st bariactric clinic didnt tell you about all the negatives of the band..

[chinamama 104]

Its not so much the manufacturer who didn't tell you about slipping and erosion it was your surgeon. .I was told that n did research n knew if I was gonna have surgery it was going to be once..the band in a lot of surgeons veiw is for people who only need to loss a low amount of weight..I had the sleeve..I would fight with you insurance n maybe point out that your 1st bariactric clinic didnt tell you about all the negatives of the band..

I really think that depends on WHEN you had your surgery. I had mine almost 6 years ago and I did a ton of research, but right around that time people were just starting to lose their bands. It was also around that time that the new and improved band was released that would deal with all the problems people were starting to have.

[christina0613 103]

I really think that depends on WHEN you had your surgery. I had mine almost 6 years ago and I did a ton of research' date=' but right around that time people were just starting to lose their bands. It was also around that time that the new and improved band was released that would deal with all the problems people were starting to have.[/quote']

That maybe true but her surgeon is still required to tell her about any complications that may happen..the band had a complications list from the start..every surgery has ..manufacturers list the complications n the surgeon is suppose to tell the patient. The insurance probably doesnt want to pay because its not medically necessary , but once it becomes so they probably will pay ..my surgeon let me know from the start ny insurance wouldnt cover a band to sleeve unless it was interfering with ny health. The same goes for a sleeve to gastric bypass. They wouldnt do it just because your not losing enough weight

[Kami63 215]

Last February, I received pre-approval from my insurance company to have revision surgery from the Lapband to the Sleeve. Yesterday, after completing the required Bariatric Program and receiving a surgery date of June 25th I was informed that my insurance company will only pay for the Lapband removal but not the Sleeve. Their reason is that the lapband is not eroded. Still, they are willing to cover the removal but not the revision to the Sleeve... it doesn't make sense. Why cover one but not the other? Or if they feel the Lapband has not failed, why not refuse the removal? My Surgeon has set up an appeal with my insurance company. I am trying to be optimistic but it feels like a long shot.

I've had my Lapband for three and a half years. I managed to lose 30 lbs only to gain it all back. I felt foolish and stopped going to the first Bariatric Center where the Lap band was done. Long story short...I did not feel supported there, I felt judged, ashamed & embarrassed.

In February, enrolled in another Bariatric Center and have faithfully followed their program. I have taken off 20 lbs but it is hard to maintain. Today is the day I was to start my pre-op diet. I will not have the band removal only surgery.... if I do, I fear that I will never get approval for the Sleeve. I have little restriction and a whole lot of reflux. It's not an option for me to get another fill as it will make the reflux even worse.

I feel that I was lied to by the manufactures of the Lapband. I was never informed that the band scars the stomach and sometimes attaches to other organs. They made it sound like it was easy to remove when in reality, it has to be cut out. They never mentioned the high instance of slippage and erosion. Constant heartburn and acid reflux is what I have been dealing with for the last two years. Medications help some but I have frequent break through heartburn that often keeps me up at night. I used to think it was hunger and would eat to get rid of the sourness and burning feeling in my throat and sometimes chest. I was later informed by my doctor that it was actually acid reflux not hunger.

Now that the shock of the denial has worn off and I stopped crying and feeling sorry for myself. I am going to fight this... fight the insurance company. I will continue with my weight loss efforts, eating right and exercising. I am hoping that the Bariatric Center will keep me as a patient, monitor my progress and help with appeals to the insurance company. I will keep applying for the revision until it happens.

I am so sorry to hear that. I know exactly what you are going through. I first started trying to revise 3 years ago. I went through two insurance companies that denied me bc they said since I gained the weight back, I was non compliant even though the testing showed damage. I finally got approved with my new insurance but my plan ends on 07/1 and I am still trying to get cardiac clearance. It has been a long fight but worth it for my health. Hang in there and maybe a law firm would help, I never thought of that option. I would go to Mexico and get it done, but I feel like my husband would not support me in the option even if we found a really good program. He still pictures old rusty equipment and dark infected rooms... Any way I wish you all the best and a speedy appeal and approval.

[Daydra 345]

Last February, I received pre-approval from my insurance company to have revision surgery from the Lapband to the Sleeve. Yesterday, after completing the required Bariatric Program and receiving a surgery date of June 25th I was informed that my insurance company will only pay for the Lapband removal but not the Sleeve. Their reason is that the lapband is not eroded. Still, they are willing to cover the removal but not the revision to the Sleeve... it doesn't make sense. Why cover one but not the other? Or if they feel the Lapband has not failed, why not refuse the removal? My Surgeon has set up an appeal with my insurance company. I am trying to be optimistic but it feels like a long shot.

I've had my Lapband for three and a half years. I managed to lose 30 lbs only to gain it all back. I felt foolish and stopped going to the first Bariatric Center where the Lap band was done. Long story short...I did not feel supported there, I felt judged, ashamed & embarrassed.

In February, enrolled in another Bariatric Center and have faithfully followed their program. I have taken off 20 lbs but it is hard to maintain. Today is the day I was to start my pre-op diet. I will not have the band removal only surgery.... if I do, I fear that I will never get approval for the Sleeve. I have little restriction and a whole lot of reflux. It's not an option for me to get another fill as it will make the reflux even worse.

I feel that I was lied to by the manufactures of the Lapband. I was never informed that the band scars the stomach and sometimes attaches to other organs. They made it sound like it was easy to remove when in reality, it has to be cut out. They never mentioned the high instance of slippage and erosion. Constant heartburn and acid reflux is what I have been dealing with for the last two years. Medications help some but I have frequent break through heartburn that often keeps me up at night. I used to think it was hunger and would eat to get rid of the sourness and burning feeling in my throat and sometimes chest. I was later informed by my doctor that it was actually acid reflux not hunger.

Now that the shock of the denial has worn off and I stopped crying and feeling sorry for myself. I am going to fight this... fight the insurance company. I will continue with my weight loss efforts, eating right and exercising. I am hoping that the Bariatric Center will keep me as a patient, monitor my progress and help with appeals to the insurance company. I will keep applying for the revision until it happens.

So sorry you are having to go through this. Wish you the best of luck on your appeal! Hang in there.

[RAAinNH 113]

My Surgeon is in the process of what they call a Peer to Peer consult with the insurance company in hopes to get their decision reversed. I will know by the end of the week if my revision will go as planned on June 25th. In the meantime, I have started the pre-op diet and have lost a couple of pounds which makes me feel good.

Thanks for everyone's support. I will keep you posted.

[aldfnp 20]

Last February' date=' I received pre-approval from my insurance company to have revision surgery from the Lapband to the Sleeve. Yesterday, after completing the required Bariatric Program and receiving a surgery date of June 25th I was informed that my insurance company will only pay for the Lapband removal but not the Sleeve. Their reason is that the lapband is not eroded. Still, they are willing to cover the removal but not the revision to the Sleeve... it doesn't make sense. Why cover one but not the other? Or if they feel the Lapband has not failed, why not refuse the removal? My Surgeon has set up an appeal with my insurance company. I am trying to be optimistic but it feels like a long shot.

I've had my Lapband for three and a half years. I managed to lose 30 lbs only to gain it all back. I felt foolish and stopped going to the first Bariatric Center where the Lap band was done. Long story short...I did not feel supported there, I felt judged, ashamed & embarrassed.

In February, enrolled in another Bariatric Center and have faithfully followed their program. I have taken off 20 lbs but it is hard to maintain. Today is the day I was to start my pre-op diet. I will not have the band removal only surgery.... if I do, I fear that I will never get approval for the Sleeve. I have little restriction and a whole lot of reflux. It's not an option for me to get another fill as it will make the reflux even worse.

I feel that I was lied to by the manufactures of the Lapband. I was never informed that the band scars the stomach and sometimes attaches to other organs. They made it sound like it was easy to remove when in reality, it has to be cut out. They never mentioned the high instance of slippage and erosion. Constant heartburn and acid reflux is what I have been dealing with for the last two years. Medications help some but I have frequent break through heartburn that often keeps me up at night. I used to think it was hunger and would eat to get rid of the sourness and burning feeling in my throat and sometimes chest. I was later informed by my doctor that it was actually acid reflux not hunger.

Now that the shock of the denial has worn off and I stopped crying and feeling sorry for myself. I am going to fight this... fight the insurance company. I will continue with my weight loss efforts, eating right and exercising. I am hoping that the Bariatric Center will keep me as a patient, monitor my progress and help with appeals to the insurance company. I will keep applying for the revision until it happens.[/quote']

Good for you, don't give in/up. I had a similar situation (erosion) and fight w/ insurance and appeal process. Hopefully they will rule in your favor. If not all is not lost get the band removed allow yourself to heal and while healing go thru the hoops required to get approved again! Hang in there!

[Mel1975 7]

My insurance went to once in a lifetime WLS policy. They approved the band out only. With the documentation of the problems, the damage done to the stomach and that I had proved medical necessity when banded. I was able to fight and get the sleeve. Check out you policy on the appeal process. I was able to do a verbal appeal and than they called the surgery center to verify and request documentation. I could not start the process until the band was removed. I think my willingness to remove the band with out them approving the sleeved really went a long way to prove the need.

Good Luck!

[shangefan 193]

I am sorry that you are having this experience and hope that you get the result that you want.

I, too, had a bad band experience. I got the band in 2009, and doctors acted like it was the best thing ever. I paid cash -- more than $11,000 for it and feel like it was a waste. Nearly a year ago, I had a revision to the sleeve. I paid cash for that, too, this time in Mexico. The difference is amazing! There is no comparison.

Please let us know what happens. Best of luck!