DENIED~

My insurance denied the sleeve.  It may have an exclusion clause although I"m not sure.  It will only cover removal of the band.  So, now I'm left wondering what I will be doing.  Yesterday I had a hysterectomy (Laproscopic) so will be figuring this out in the weeks ahead.  I can have the band removed and therefore eliminate my complications from that or leave it in and wait some more.  I will be contacting the WLS to see if there is anything he can do or how much it would be cash pay.  I'm a bit too tired and in some pain to make a decision now.  But any input would be welcome. 

I personally would not want to wait until the band complications got worse to remove it.  I'd want to do the removal ASAP regardless of revision.  

Totally agree with Gwen, the band is a ticking time bomb, get it out before it causes life long damage. I developed gastroparesis or slow emptying stomach from my band and that causes all kinds of horrible stomach pain and digestion problems. I'm in awful pain at least once a day for hours at a time just from this issue alone. Then there is the loss of some of my swallowing ability, I don't swallow correctly anymore because of the band. It cause so much damage even when it isn't causing pain! So please get it out as soon as humanly possible, don't wait on this at all! I know a few people that have even had to have their stomachs removed completely because of the damage from the band. Plus there is also the possibility of Barrett's esophagus which is a precancerous condition, so don't jeopardize your health get it out now! Then find out about the insurance coverage I thought if they covered one type of surgery they had to cover all of the main four anyway. Medicare started covering the sleeve a couple of years ago and that is usually the standard that most insurance companies go by .

Most of the time, surgeons do the band removal and sleeve surgery at the same time -- called a band-to-sleeve revision. If it can all be done in one surgery, why put yourself through two surgeries and their attendant risks and recoveries? Especially now that you've just had a surgery. Your insurance is nuts to cover only the band removal and force you to have a separate surgery to get the sleeve. Two more would be double the trouble. Good luck with your recovery from your hysterectomy and with your insurance company.

psychoticparrot

One of the questions I will have with him is the cost of doing the sleeve while removing the band.  I would imagine the cost would be less?  Not sure.  I guess we'll see.  I appreciate all the input. 

I think that would be the case, because you'd only need to cover hospital fees and anesthesia for ONE surgery, as opposed to two procedures.

Unfortunately some insurance policies do not cover revisions from a prior bariatric surgery. Your best option is to ask the surgeon who will remove the band what the additional cost will be to perform the VSG at the same time. If you can't afford it now, I would still suggest that you get the band removed asap.

Tough situation. It's completely unfair but insurance companies are notoriously cheap and looking for excuses to avoid paying for anything.

I just had my band removed and revised to the sleeve along with a hernia repair last week. I too was approved for the band removal but not for the sleeve. I couldn't and didn't want to wait to have it out, didn't want more permanent damage, there was already a chance he wouldn't have been able to revise but did.

I unfortunately had to self pay and are now seriously in debt, but aren't sorry I did it and glad I did it all at once.

Once again I wouldn't wait though to have it out the band is a ticking time bomb......

Good luck, keep us posted

Do some research into insurance -- yours and other carriers. I had to get my own policy from the health care exchange to cover my surgery, because my company switched insurers and the new one excluded bariatric surgery. 

In my state, it turns out that while corporate health plans can still exclude bariatric surgery, it is a *requirement* for individual plans through the health exchange. I believe that is true in at least 23 states. You could switch plans during open enrollment at the end of the year.

Also, when trying to figure this all out, I learned that in my state, it would be required for all corporate plans starting next year.

So it may well be possible that you could find insurance that would cover the VSG in 2016. It's worth the research, at least.

I will check it out, thanks.  I am in Texas so likely they are not going to put such stipulations on insurance companies but you never know.