Lap Band already removed now want a DS

 I had a lap band in 2003 and had some weight loss but struggled with reflux and eating very small amounts but always feeling hideously uncomfortable. Anyway, the band needed to come out because of this and a dialated esophagus, but the surgeon wanted to let things heal before doing a revision. 

I have Aetna and am being told that although their policy has a provision for revision that because mine won't be done at the same time as removal, that I have to do the 6 month Dr. supervised weight loss. 

Has this happened to anyone else or can anyone offer me any suggestions?

Thanks!!

That's Aetna. You can try to fight it, or you can do the 6 months. BCBS required the 6 months even for a revision (unless it was due to mechanical failure).  I'd do the 6 months of supervised dr visits.

 Thanks. I already have an appointment with my PCP on Thursday to count as Month 1, but this is one of those things that I guess I just have to accept and make the best of it. I gained weight soooooooo quickly once the band came out, faster than I ever have before in my life, and I just hate to see what the next 6 months will bring. I know all the right things to do, but it seems like such a long time!! 

Did you read the policy? Although to get a new surgery, you have to do a six month diet, a revision only requires that you meet the revision criteria.
"Repeat Bariatric Surgery:

Aetna considers medically necessary surgery to correct complications from bariatric surgery, such as obstruction, stricture, erosion, or band slippage.

Aetna considers repeat bariatric surgery medically necessary for members whose initial bariatric surgery was medically necessary (i.e., who met medical necessity criteria for their initial bariatric surgery), and who meet either of the following medical necessity criteria:

Conversion to a RYGB or BPD/DS may be considered medically necessary for members who have not had adequate success (defined as loss of more than 50 percent of excess body weight) two years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure; or
Revision of a primary bariatric surgery procedure that has failed due to dilation of the gastric pouch is considered medically necessary if the primary procedure was successful in inducing weight loss prior to the pouch dilation, and the member has been compliant with a prescribed nutrition and exercise program following the procedure."

If at some point during the last 7 years you went to a nutrition class and the doctor can show that you didn't do anything wrong, then you shouldn't need the 6 mos.

 Thanks. I have seen a dietician, but did not take a class. It is worth looking into-thanks!!

 I'm sooo sorry this is happening, it's not right!!  I too have the exact things happening to me and have since about 3, 4 weeks after I got my band.  I felt like a complete failure for just a short time tho and moved on.
I haven't had the band removed because I didn't want two surgery's but I'm glad now because of what your going through-dam insurance companies!!
It would be futile for me to have a 6 month diet at this point because I eat so little and when it does stay down, I stop at 3,4 bites or just drink liquid so I've basically been on a liquid or pureed/soft diet.
Good luck my friend and I'll be watching for your updates!

 Thanks, Ronda. I am sorry you had issues so soon, but it is good that you are moving on. If I have to do the 6 months I will. My PCP is supporting me so we are going through the motions to get the documentation, but it does seem like such a long time away. I will actually be on my 3rd surgery since I had to have the lapband removed because I was miserable when I ate anything. They did not want to do a revision at that time, but I am so glad they didn't because I did not even know about the DS at the time, and now I do and am convinced it is the right revision for me.