Never thought I would be here.

Exact same position.  Heck we could have been on here at the same time rejoicing that we were getting bands.  I'm in the middle of my revision approval process.  I've gone to the doc, he sent me for the barium swallow x-ray test and an endoscope test to take a look at the band.  Those you could do with the referral guy while your waiting for you main doc to get back.  I've since spoken with my doctor about revising to the sleeve and he's all for it and has it approved in his paperwork now.  

However now the will insurance dance comes into play.  I have BCBS and I'll explain why that don't mean a thing.  Each employer has the opportunity to renegotiate the terms of their insurance coverage so I really have BCBS UT Select, so I can't compare my coverage with any other BCBS patients as it'd be different.  So call the number on your card or visit your insurance's website.  Mine doesn't have anything about revision on the website and when I called the guy reading me the policy also didn't see anything about revision.  So that's what my docs office needs to help me with.  As I'm not going to assume it means yes when it might mean no.  

So what to do if it's not covered, well it's a 5k deductible in the first place for my insurance to cover the surgery, it's $13,500 to have it done as self pay.  Waiting for the insurance to come back with additional requirements might be as long as a 6month weight loss program, shrinks, and so on.  So you have to decide if you want to wait for a possibility or go for the sure thing.

*Please note though I've been reading that if you self pay and have complications your insurance may not cover those either.  So inform yourself very well and be sure you understand the full deal with both options. 

Good Afternoon YellowTJ, 

Wouldn't that be a hoot if we were on here eight years ago singing joyous noises at having the band surgery scheduled. If only I would have had foresight. I have BCBS. I just called them and they said that all I need is a letter of Medical Necessity. I have already talked to my surgeon and his office. They have been here with me this whole time and know all to well the trouble I have had from the get go with this band. I am hoping this all works and I can get my revision. I had forgotten how much support I got on this website. I am so thrilled to have found you all again. 

Dottie

Joyful noises! What a hoot, right.  I also have BCBS, the office has submitted the insurance request as of last week.  We're not sure what they will requires specifically.  My band is not technically malfunctioning.  In that it's not broken or yet eroded or flipped.  I'll just hope good hopes and we'll know more in 3-4 weeks.

I had the revision from band to RNY on 9/1/16.  So very glad I did.  I noticed from the moment I took my 1st sip of water after surgery that the band had been removed.  I had them both at the same time. I would not have wanted it in 2 different surgery's. 

You definitely need to check with your insurance company and the Dr you choose.  Every insurance can be different as well as the Dr.  I have heard some Dr's will do the whole removal and revision at the same time and some will not.  It also depends on what they find while doing the surgery itself.  Insurances?  Well don't get me started on that but I was worried mine would not approve a revision as I knew of quite a few they had denied.  My particular policy has a "1 bariatric surgery for the lifetime of a policy" clause so I called to find out what the what was with them and they said while it is true they "usually" only allow 1 bariatric surgery it is not automatic denial, they will review for medical necessity.  The hard thing to swallow is they (the insurance people) get to determine the medical necessity of it.  Mine was approved without any fusses except I did have to go through the whole 6 month process of going to appts and classes and meetings and such so I didn't know until that 6 months was up if they would actually do the surgery.  My insurance also has requirement that my BMI was 40 or higher or 35-40 with comorbidity which is where I fell. 

I had such bad heartburn and acid reflux I was so ready to have the band out which had in fact slipped at some point but apparently moved back and there was scar tissue and swelling.  I had esophageal ulcers.  My Dr would not do a Sleeve on me since I had the reflux/heartburn issue.  Apparently that is a very common side affect of the sleeve.

Im super happy I did the revision and feel a world better.  Back down 55 of the 80lbs I had gained back.

I wish you the best in your journey.

This support site is so very helpful.

Peace.

Hi Dottie, I can't answer the insurance questions because I am not in the US. But I can tell you that we were banded at the same time and my experience with the band has exactly the same. Things got so bad that I had mine removed Oct last year. I have put on 30 pounds since then!!!  Like you say, I never thought I would be here, I had good weight loss with the band, over 100 pounds, but I paid with my health. I am so greatful  to be rid of it. I am having RNY 15 Mar and can't wait, the unrestricted me is a volume eater!!  Good luck, hope all goes well with the insurance.

Cheers Flaxie

Congratulations of both getting rid of the bad band and getting a revision. I am excited to get this process underway (which it really is) and get on with getting my health back. Lap Band was a bad decision for me and lots of  others evidently. 

Thanks so much.

Dottie