band erosion-possible revision to sleeve

I had an endoscopy today & found out that I have erosion & will be having to have my band removed.  I'm wondering how many others have had this happen and if you've been able to get your insurance to approve your revision.  I know that I cannot replace with another band.  My Surgeon said I could go to RNY but that he would reccommend the sleeve.  From the things I've read I believe I would love to have my band replaced with the sleeve.  I am under the impression that most insurance do not approve the sleeve.  Any advice here?  Thanks for your help!

Hi Mary,
I just wanted to say how sorry I am that this happened to you.  I thought that most insurance companies didn't pay for the sleeve either, but it might depend on how/why your doctor words it.  I hope that you get some useful responses here.

I'll be thinking of you,

Lenore

Thanks, Lenore for your concern.  I have been very happy with my band & will be very sad to lose this tool.  Hopefully we can get things worked out so that I can continue on with a new tool.  I fear trying to do it alone & putting weight back on.  I have changed alot on this journey but I do not want to return to where I came from, if you know what I mean?  I meet with my surgeon Monday morning.  He is also the one that did my endoscopy & he reccommended the sleeve to me.  Hopefully it will work out for me.  I know the Lord is in control of my life, no matter what happens.

Mary

I DO know exactly what you mean.  After my unfill in March, I have had some small fills, but I'm still not up to my previous fluid level.  As a result, I can eat any and everything.  I always think that I'll do so well in the summer, but I actually do much better with the structure of school.  I had gained about 10#, and it's been so hard to take them off.  Without my band, I can easily see myself reverting to old habits and weight gain.  I so understand what you are saying. 

Lenore

Good Morning!

I am similar to your story. The band did not work for me so I am going to have a revision done with the RNY and the Insurance approved it. I have United Health Care. I also believe it is the right wording the Doctors use when they send in the Letter for Approval. My Dr. did not think the Insurance would pay for the Gastric Sleeve so he suggested the Revision with the RNY.

Please don't worry o.k.! I had the endoscopy earlier this week and I have a little erosion but they also found out I have Helio bacter pylori which is an acid bacteria that can cause Ulsers so they called me in a Prescription to clear that up before my Surgery August 4th.

I started my 10 day Liquid Prep today so I can deplete all of the sugar in my body so my Liver can Shrink. this way it give the surgeon more room to work around and it is safer.

I have also read and heard good things with the sleeve so I believe you will be in good hands and your sleeve will get approved. Remember God is in control of this!!!

Keep me updated o.k.

Cynthia

Hi, my story is I had my band removed in August 2008 due to a slippage and serious GERD.  At the time, my surgeon's LOMN was for a removal of the band and a revision to the VSG, but insurance approved the removal and denied the VSG (experimental/investigational denial), and I decided to self-pay in Mexico with Dr. Alvarez.  When Dr. Alvarez opened me up, he discovered that my band was buried under layers of scar tissue, and because it was so hard to remove my band, he decided to forego the VSG and advised me to wait 6 months before another surgery. 

Well, here I am almost a year later and I feel like my stomach's healed enough to pursue surgery once again.  Only difference is this time I've decided to revise to the DS.  After researching, I discovered the DS still has the restrictive portion (VSG), but it also has the malabsorption component, which I think I need at this point.  What's even better is the DS is covered by my insurance (UHC), so I'm just waiting for the surgeon to submit the letter or medical necessity. 

As far as insurance and the VSG, I think only BCBS Federal is approving the VSG without a fight.  Most other companies are still invoking the experimental/investigational language to deny the surgery.  If I you have your heart set on the sleeve, I would still have your doctor submit and see what happens; if you get a denial, then definitely appeal.  If you appeal and they still deny, you may have to consider a surgery that they cover or look into self-pay options.

Good luck in your journey! 

So you didn't have your insurance pay for having your band removed?  I guess you were just gonna go to Mexico & have one surgery where you had your band removed & your VSG done at the same time?  Sorry things didn't work out the way you planned but that's the way things go sometime.  Hope all goes well with your DS & that you will be pleased.

Well, my insurance approved the band removal, but they wouldn't pay for a sleeve revision.  They would have paid for the RNY, the DS or another band, but I wanted a VSG at the time.  You're absolutely right though, everything happens in its own time, so I didn't get too stressed about the whole thing.  And thanks so much for your well wishes.  I hope everything goes according to plan for you as well!   

Hi I have had a similar problem with band and actually in the process of removing my 2nd band in August and converting to an RNY ...  i was told the same thing about the sleeve and insurance denial.  The sleeve is still considered experimental and so because of that plus the fact that the sleeve works on the same premise as the band (restriction), I was told if you haven't had much successs with the band alone, it is likely that the sleeve will work the same way which is why they are recommending RNY.   There was a period of time when the band was working well fo rme and i did love it as well, but eventually it stopped working effectively and now I am just frustrated with it.  Good luck to you.

That's what I have heard as well.  I have a Molina band (non adj) and was at the dr yesterday for severe acid reflux and he recommened converting RNY.  I asked about sleeve and he said there will probably be to much damage from the band being removed to go to the sleeve so I am opting for bypass.  I'm not sure what band you have but mine is one that adhere pretty bad to the stomach and they have a hard time getting it off.  Hopefully yours wont be that way.  How long have you had your band.  I have had mine 6 yrs and have kept my 80 lb weight loss off.  I was surprised since I am no longer obese that I would qualify for bypass but I do with all that is going on.  Keep me posted on your progress and I will as well.
Angie