Help with appeal

I had my original lapband surgery in Sept 06.   Had a slip in Oct 07 and had band unffilled for about 3 months and started getting fills again.  During the time I was unfilled I regained 25 lbs.  I was fine until Aug 08 and had a really bad slip and had to have the band removed due to inflammation of my stomach, my surgeon was not able to reposition the band or replace at that time. 
I first tried for a revision to VSG, but was denied for that  because my company United Healthcare does not cover VSG.  I then had my surgeon submit for another lapband.  I want to try that again, because from what I understand, the newer bands are less likely to slip.  I got a denial today for that because my BMI is now below 40.  Does anyone have any experience with getting a replacement band, and did you have to meet the original criteria?  I have already regained around 20 lbs since I  had my band removed.  I did really well with weight loss with the band, and I'm sure I wil gain the weight back wthout it.   I am going to file an appeal, but wanted to see if anyone has any suggestions on how to handle the appeal.. I think since I can prove the band worked for my weight loss and without it i have regained weight twice, they should pay for a second band.   Any  help would be appreciated. 

Hello!
Yes, you can appeal this and it is a very hit or miss situation, Most insurance companies will make you meet the original criteria. Some insurance companies even have a contract with your employer group that says, "...only ONE weight loss surgery per lifetime, per member..." But, if you were denied because they say you don't meet the criteria, then I would suggest having your surgeon do a peer to peer with your insurance company. This is when your surgeon and the medical director who is responsible for your case at the insurance company have a conversation about what is going on. This can be very effective! I hope this helps.
Best wishes to you!
Billie

 Is your BMI above 35? Did any of your comorbidities come back? Have you considered getting the DS (duodenal switch)? Why would you want a revision surgery to another band if they first one has already failed you? If you have documented mechanical failure of the band (and don't have an exclusion in your insurance policy) I'd look into getting something besides a band. The VSG is still considered experimental/ investigational by most insurance companies but the DS is not. It has been done since the 80s and is even covered my Medicare. Check out the DS board. There are quite a few lap to DS revisions on there. Best of luck to you in whatever you decide. Don't give up though and appeal, appeal, appeal. PS do you have your EOC (evidence of coverage) it should tell you your insurance's specify criteria for WLS and revisions.