RNY or Lap Band

I would rather (hope) that I can have the Lap Band surgery rather than the more risky RNY surgery. My only problem is my Insurance Company Med-Pay out of Springfield Missouri will only pay for the gastric bypass surgery(exactly what my booklet states) and I have to have a BMI over 40 with the co morbid obesities. I have the Co morbid and I am currently at 39.8( I can get the 40) but how (once they approve me) can I get them to pay for the Lap band. What type of letter exactly do I need to send to my Insurance company? It costs less for one reason, alot more risky with the RNY,and just over all less problems(it seems through the OH site. 

I am afraid of starting a huge lap v RNY issue on here, so I'll only say this... research, research research!  Maybe you could call your insurance and ask the WHY they don't do lap band... you could also call Dr. Hornbostel's office (even if he's not your surgeon) and ask why it is that he doesn't preform lap band.  I just did two papers for my english class about lap V RNY and another one...  Maybe the first thing you should do is call your insurance and ask the WHY.  That may give you some good answers.  At least you'll understand their reasoning. Good luck with it! ~Christine

cHRISTINE YOU ARE BRAVER THAN ME I DELETED MY ANSWER LOL.....

I'm not scared....I'll just jump right in there and say what I know you want to Chris....I will tell you why my insurance co. won't pay for lap band....the success rate is low.  Yes it is an easier surgery, but the main reason an insurance company will even consider any type of WLS is because of the overall improvement of health of their client which will save them money in the long run.  If the surgery doesn't have a high success rate...why waste the money...btw...there is documentation out there that shows that people who aren't successful with lapband end up having the RNY anyway.  I encourage you to do heavy research.  There are just as many problems with the bands, if not more.  You get the restriction from the band and i have heard of people having to have that adjusted over and over again and even replaced because they "pop" it.  I'm not trying to convince you to have RNY...you have to do what you are comfortable doing.  It's your life and your body...but if you are leaning toward the band because you think there are less complications i think you need to do more research...that's all.  Best of luck to you.

Hi, I have had RNY and I chose it because from what I researched, there is alot more success with it than the band....longterm!!! The only reason that made sense to me to choose the band over the RNY was simply an age and pregnancy related thing. It is easy to un-do the restriction of the band if you become pregnant...since I knew that wasnt in my cards, I choose the one that I thought would be more long term successful for me.  As far as the cost, the reason I was told by a Dr who performs this surgery daily is that it doesnt take as long to do it so it costs less! Pretty straight forward and simple. Please do more research and check out long term results...the ads look good but they dont always tell the whole story!!

In making your decision I would research both surgeries as much as you can and decide which one you think is best for you. Maybe you could attend a seminar (there shouldn't be a fee to attend) for a surgeon who performs both surgeries. This is what I did and honestly when I left the first one my mind was made up that I would have the RNY (my insurance will cover either).  After further going over information and attending another seminar ( I have been to 3 different ones total) I changed my mind to having the LapBand surgery. I think this would be the best for me and you will have to decide what is the best for you. I chose LapBand because though you will initially probably have a greater weight loss with the RNY after 5 or so  years some people start to gain weight back where with the band you can keep up with the fills and maintain weight loss longer. With both you are at risk for pouch stretching of course if you eat more than is suggested which could cause weight gain with either surgery. Also if you have a lot of weight to lose and lose it fast your skin will be loose and I think if you lose it slower as with the band you will have time to tone up as much as you can and there may not be a need for any plastic surgery. Again all of this is just my opinion and not meant to make anyone mad,just don't see many people on here who have had the band or many that seem to support having it done so I thought I would give you my input. Good luck with your insurance and I hope things fall into place for you no matter what you decide.

I had Lap Band Surgery on 01/26/07 and have lost 66lbs. It's slower than RNY but I'm happy with it! Everyone, including doctors have their own opinions!! Do your research!! Deb M

Either surgery can be a success or failure - it all depends on you.  I'd do what someone else suggested and call the insurance to see why they don't cover the band.  I'm very happy with my band.

Hi there, I just wanted to let you know that I, too, had originally decided to have the lap band-due to the procedure being less evasive and such. I had my mind set on it. I ran into the same problem as you, that my insurance would NOT cover it. It didnt matter HOW many appeals I sent in (4 total AND I did insurance/hospital paperwork etc myself for 14 yrs, so I knew how to word it and what documentation to send in etc) it was NOT going to happen. One of the reasons that my Blue Cross insurance didnt cover it was because it was a life long thing of having them pay for fills, for f/u visits and such-as long as you have the band-they are going to be paying for visits. Yes, when you have the RNY, you are going to the doctor a couple of times that first year-but then its just a yearly check up. They also state that a lot of patients, when the band is removed, gain back the weight.  Anyway-I ended up choosing the RNY simply because I had a very high BMI and I wanted the weight to come off as quickly as possible, as I was very desperate for that. There are complications with both surgeries. To each their own-I dont envy what you are going through-and I would sincerely take everyones advice and research, research, research-till your sick of it.  Good luck to you.  Janet