NoMoBand 278 Posted February 27, 2015 (edited) Got the dreaded call today. UGI showing my esophagus is in trouble due to dilation and other issues with stretched pouch, then, to complicate matters my new insurance does not cover the bariatric programs in my local town where I got my lap band and I have transferred care to the new insurance bariatric program 400 miles away. I have an appointment with the new doctor in 3 weeks. The call today came from the new clinic letting me know that the band needed to come out and revision to sleeve will be done 6 months after band removal. I did not want to hear either one of these news. So, I understand the 6 month wait due to scar tissue caused by the band and time to allow healing. My question and concern is undergoing 2 surgeries, what are my chances of getting approval for the sleeve after lap band removal? What I am hoping to hear is that revision approval (if there is such a code) includes band removal and sleeve after the six months. What I am unfortunately expecting to hear is that both removal and sleeve are two separate approvals. What if I don't meet insurance requirements to qualify for the sleeve after removal is my biggest fear! I've been successful with my weight loss and the band, however, will my BMI meet the requirements after band removal? Will I need to gain weight to meet the BMI requirements? I will be devastated if I end up with no weight loss tool of any kind. Just with a few times that I had complete unfills of the band, I started gaining weight quickly. Anyone have any ideas how all this works? All insurances companies are different and I will contact mine to get more information, but, I am afraid I will end up with nothing. Jake Edited February 27, 2015 by jakealta Share this post Link to post Share on other sites
Md_bander 3 Posted February 27, 2015 I am almost in the same boat. Banded 2010. successful first 2 years. Lost 70 lbs. Lots of fills and unfills in the last 2 years. I had no medical support. Found a new Dr. who I just adore. His office is amazing. I was told my band must come out. I have been "empty" since before xmas and have gained 25 lbs. My band will come out 3/27. Approved by Cigna. I have to wait 3 months for sleeve. ANd, pray that they cover......the only comorbidity I have now is sleep apnea and Hi cholesterol. The wt. gain has brought up my BMI....I also pray that Cigna covers my sleeve........because no tool is very dangerous. My saving grace........my husband, who is a major contributer to my wt gain.........was sleeved yesterday. So, if I can't get it, at least there will not be as many temptations to deal with. Good luck with your next chapter. Share this post Link to post Share on other sites
LSF 264 Posted February 27, 2015 I have Cigna and had my revision done in 1 surgery which they approved. This was after the 3 month requirement was met Share this post Link to post Share on other sites
melissa808 5 Posted March 1, 2015 I have bcbs and they covered the removal and then revision to sleeve three months later. There were separate approvals but the doctors usually know how to get them. If they can show that the band worked for you initially and once it stopped working you gained some weight I have heard that they will most times approve it. Good luck! Share this post Link to post Share on other sites
Liz W 11 Posted March 2, 2015 Hi guys, your posts help me a lot. Just last week I had my band removed, saw the doctor on Monday and had a surgery on Wednesday. He said I have a huge leak, a hole in my stomach, infection and the rest. I was also running fever for about 2 months, no doctor knew what is going on, antibiotics didn't work. So I had an emergency surgery. Stayed in the hospital for 5 days. My doctor is telling me he will do the sleeve surgery after about 3 months, when my stomach heals. I still don't feel good, still have a slate fever every day, I am on full liquid diet, but day by day is better. Going back to the clinic next Monday. I had my band for about 3 years, always had a pain by my port, but the weight loss was good, about 85 lbs. I loved my band, I'm a little scared about next surgery, but I don't want to gain the weight!!!! Share this post Link to post Share on other sites
NoMoBand 278 Posted March 3, 2015 (edited) Liz If you don't mind me asking, what were your symptoms? You mention fever, anything else? Let me tell you I am freaking out! Now it seems like I'm starting to experience things that I have not experienced before. Could just bestress related or avery cold storm that has come through. I am now experiencing night coughs and reflux. I am sleeping with 3 pillows to keep things down and my band has tightened up so much that I have to sip Water very slowly at times. I am very grateful for the band and will miss it! I am also scared about the next chapter. Edited March 3, 2015 by jakealta Share this post Link to post Share on other sites
Liz W 11 Posted March 3, 2015 My symptoms were pain in the port area, every time I ate it felt like the food is not going down to my stomach, felt like its was going to the side, inside my port, or the wires, the area was painful and sensitive. When the doctor check it on the xray he saw it too, it looked like a big leak. I never had any coughs or reflux, but I do have Barrett's and was taking my meds. At this point they left me without anything, I am so scarred that I'm going to gain the weight I lost. Liz If you don't mind me asking, what were your symptoms? You mention fever, anything else? Let me tell you I am freaking out! Now it seems like I'm starting toexperience things that I have not experienced before. Could just bestress related or avery cold storm that has come through.I am now experiencing night coughs and reflux. I am sleeping with 3 pillows to keepthings down and my band has tightened up so much that I have to sip Water very slowly at times.I am very grateful for the band and will miss it! I am also scared about the next chapter. Share this post Link to post Share on other sites
