so my surgeon said... Please help me.

[lalaj 108]

i saw him today and asked about revising to a sleeve. he said insurance would never approve because my weight is too low. has anyone been through this? this has discouraged me. i am very unhappy with my band and it has been difficult to eat. All he said was let's do an adjustment. now i feel like there is no hope. i have to live with this band or get it removed. this sucks but i knew what i was getting into when i got the band.

[fezik23 240]

Would it help to get a second opinion? Some docs are more willing to advocate for you with the insurance companies.

[LadyPullings 94]

If you have the comorbidities and qualify for the surgery there's no reason you should get denied! Tell him you want to try it anyway!

[Nevermind 117]

If he's not willing to advocate for you, try another surgeon. A second or third opinion cannot hurt. Hope you get the answer you need soon.

[une nouvelle vie 327]

Is your current weight is correct at 158?

[Domika03 309]

I had the band & was revised to the sleeve with a pre-sleeve weight of 155 at the time of my revision. I was having trouble with the band, which was documented, as it had partially slipped. While I had a lower weight, Kaiser CO did approve me. Mind you, my band was done through a different insurance company all together, so I thought for sure I wouldn't get approved. I was thankful as all I had to pay was the deductible ($1500).

I would consider another surgeon that might support you. If you continue to 'have issues" & it's documented, you may be able to get the revision.

[RickM 1,747]

In general, your surgeon is correct that insurance won't cover it if you don't have a qualifying BMI (the typical 35/40 depending upon comorbidities) but it never hurts to ask. I have seen, as Domika has experienced, people get the revision when the band is giving problems, so as with reconstructive surgery, it seems to get down to that old "medical necessity" problem. If you can document problems with it, particularly to the extent of it having to be removed, then there is a good chance for it. Beware of policies that limit a person to only one bariatric surgery per lifetime.

[thesuse2000 698]

Your surgeon gets paid to do surgery, so if he thought there was a way to get it done I can't see why he wouldn't try. But - perhaps he just doesn't know how to make it work. You'd need to have documented health problems due to the band to have a chance. As suggested, perhaps another surgeon can help. I wish you luck!

[lalaj 108]

Thank you all. I will seek a second opinion. It doesnt hurt to try. I appreciate all the feedback.

[manuela 11]

Lalaj- I am in the same situation you're in!! I had a lapband done a yr ago, I could never get more then 4.5 ccs because it's to tight!!!! I eventually had a slippage, got it unfilled!! I have not lost any weight and every time it eat I get terrible pain on the port area. I talked to my dr about a revision and he is not for it because my bmi is too low, the last time I weighed in I was 153. So, I decided not to fight the band anymore and indulge myself w. food until I weight where I need to be!!! Is this too crazy to do?!?! What do you think?! Mind you, I'm self paid, thankfully I purchased insurance that will cover any complication and it's good for another year. The insurance will pay for or and removal of the band and I will have to pay for the sleeve!!! I'm finding my self soooo discouraged!!!!

[OCSlim 63]

<p>i saw him today and asked about revising to a sleeve. he said insurance would never approve because my weight is too low. has anyone been through this? this has discouraged me. i am very unhappy with my band and it has been difficult to eat. All he said was let's do an adjustment. now i feel like there is no hope. i have to live with this band or get it removed. this sucks but i knew what i was getting into when i got the band.</p> <p> </p> <p> </p>

Hi Lalaj,

My insurance won't cover for me, so I'm self paying and having it done in Mexico. If you haven't already, you should check it out.

I'm having it done via a single incision through the belly button, so less scarring and faster recovery.

Good luck to you!

[Jerzeegurl0815 2]

I was 160 at time that approval was gained. my doc was a true advocate, highlighting my comorbitities, family history, and chance of weight gain. Because I was lower weight my doc did not make my stomach super small, but I do understand that it is just a tool...to date loving it more than my band!!!