Has anyone received a denial just for Band Removal?

[kristenmh 68]

I'm on pins and needles waiting for an approval to remove my lapband. Has anyone received a denial just for band removal? We didn't request the conversion to Sleeve yet -- my doctor wants to wait until three months post band removal.

[Karen1961 5]

My insurance company will not cover removal unless the band is damaged or is causing major complications. The reason for waiting (according to my doctor) is so that you will be completely healed from the band. Also, the success is much better if you wait. (so I've heard and been told). I go next week to get my band removed, it's been in since 2003, I'm so ready for it to be out, it never worked. I then have to wait 3 - 6 months for the sleeve.

Best of Luck!

[Sai 785]

I'm on pins and needles waiting for an approval to remove my lapband. Has anyone received a denial just for band removal? We didn't request the conversion to Sleeve yet -- my doctor wants to wait until three months post band removal.

Only if there are no complications, but mine was a minor complication from being too tight and on second appeal they accepted it. I had no comorbidities so it surprised me they approved it to be honest. Mine was a band removal to sleeve though, one surgery.

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[Aggiemae 739]

3 of The 5 people in hospital when I got my sleeve where having lap bands removed.

About 10 years ago I went thru the whole process to get a lap band but decided against it after I had to have two (way expensive) dental implants removed due to an ongoing auto immunity problem. I spent the past 10 years flossing and regaining the same 50 pounds but I think I dodger bullet.d

[kristenmh 68]

My band removal was approved on Friday afternoon! Woohoo! Of course, I wish we were doing the removal and sleeving at the same time, but my doctor would like me to wait 3 months before being sleeved.

[mrobles1027 7]

I was given a partial approval to my pre-authorization today. I was approved to remove the band but denied sleeve. Doctor is going to do a peer-to-peer appeal this week so Im hoping to get good news. Ive had so many complications with the band that is just stop working for me.

[kristenmh 68]

I was given a partial approval to my pre-authorization today. I was approved to remove the band but denied sleeve. Doctor is going to do a peer-to-peer appeal this week so Im hoping to get good news. Ive had so many complications with the band that is just stop working for me.

I am so sorry to hear that! You might want to talk to the lawyers at wlsappeals.com -- i did a free consultation with them and they were super helpful.

[Mimi52 103]

My removal was approved but sleeve denied. I appealed with help from Dr and won appeal. Had one surgery on 9/27. Removal and sleeve. Dr did tell me that if she did not feel could do both once in there would only do removal, but everything worked out. My appeal showed that I did lose weight initially with band but had slips (which meant all Fluid removed for 3 months at a time) the would have to work back up, never could find right fill. It was a lengthy appeal but it helped me win. Good luck

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[IMissVegas 23]

BCBS won't pay for my band removal even though I have a lot of port site pain. Of course the surgeon wants to do a revision, but they've denied it twice.

I plan to appeal.

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[Irene B 0]

I live in Australia and I had my band in 2009. No problems, our health fund paid for it. In 2014 I finally wanted it removed but between 2009 and 2014 our health fund stopped approval for banding (which also included removals). When I first had a date for removal with my surgeon I then went to my health fund and they approved it and three days before surgery the hospital rang to say that the health fund weren't approving the removal. I explained to the hospital administration that the health fund had paid for the original banding and as such I thought they should pay for it's removal. I did speak with the health fund but they just kept saying they would get back to me, but of course they didn't bother. In the end it was the hospital that got it over the line and my surgery went on as intended. It was such a relief to have it out. I changed health funds straight away after my surgery, I was disgusted with how I was dealt with. I'm hoping to be sleeved early next year.

[ZinNH 173]

My band removal was denied at first, so the doctor had to prove that it was causing problems. An upper GI showed reflux issues or something, and then it was approved. That was about five years ago.

my sleeve was approved the first time.