band to sleeve with Aetna? anyone?

have had my band for 3 yrs -- 4cc band and at one point had 4.6cc's in it to get restriction and even at that it was not that great.

lost 70 pds -- 1st yr -- nothing but gain and loose the same 10pds since -- had plastic surgery to get rid of my tummy (TT in Jan) and since have gained 20 pds (had to remove fill and now back up to 3.5cc's)

the challenge I have is there is not alot of "fat" on my stomach - so I need to full fill to get any since of restriction - and it's not that restricted

I have Aetna - and my BMI is now 40 so still Mob Obese

Anyone have luck with Atena paying for a sleeve?

No luck here!  I, too, lost 70 lbs. the 1st year with the band, then leveled out.  By the end of the second year my reflux was so bad the band had to be removed.  I wanted a sleeve, but Aetna turned me down.  They would cover RNY or DS but not the sleeve.  I went with RNY and I'm so glad I did.  Sorry I didn't do it the first time around.  My surgeon told me that the sleeve, in my case, probably wasn't the best revision because it wouldn't have solved the reflux issue. RNY has completely solved the issued and I'm at my goal weight.

Good Luck!!

Debbie

Aetna and United Healthcare are now covering the sleeve.   I have UHC and am also working on trying to get a revisiion from band to sleeve.   Good luck with yours. 

yes, I just read they covered it --- wondering if I have to do anything heroic -- like letters and pictures like I did with my band -- or will the doc do his magic

what are you doing?

I have Aetna and I have a band. My doctors office sent in a pre-determination letter and I was approved with no prerequisites for re-banding or VSG. I have the letter in hand...woot-woot. I know of some others who have been told that they must see a nutritionist for 3 months then submit. But they will cover it, I am just waiting to be scheduled.

great news

can you tell me what your band challenge was?

weight loss
slips
etc

what did you doc put in the pre-determination letter?

I havent done anything yet.  Just talked to my doctor last Thursday about submitting to insurance.  Hopefully, they wil handle everything.   I am just waiting to hear from insurance.

I had a slip twice. I was supposed to be rebanded in November but I was told that the band had done some major damage to my stomach when they opened me up. I'm not sure what they sent it. I was told that it was actually a nurse at Aetna who suggested that the practice submit a letter. I think it was just my prior history though.