trying to help...

my mom had the lap band almost 2 years ago. She had wanted the sleeve but our surgeon wasnt doin it yet so she got the band. Big mistake. it worked for about six months and then they overfilled cause esophagial inflamation. and then fallowed all the other band complications. unfilled refill and not working and she has put back on 40lbs. she wants a revision to the sleeve but doesnt think her insurance will pay for it...origianlly she would have had to have a bmi of 50 to get it. she has Health Plus of MI. I am hoping someone has experience with them and can get me some info. I think she has ju8st given up and is eating her way back up to a 50 bmi, which is so unhealthy. I have guilt because I got my VSG and my sister is doing WW and doing great. but I want my mom to be happy too.
So does anybody have info on Health Plus of MI that I could use to help her??? I think she should try to put in for it and appeal if they dont approve it. but I know she's scared that they are going to take away her band and leave her with nothing.

 
What is her current BMI?  If she wouldn't qualify for WLS without needing a revision, she won't qualify now.  She needs a BMI of 35/40 with/without comorbids and to wait 2 years after her original band.  Then she needs to see if her ins has changed to once in a lifetime WLS.

Going to a surgeon that does not do all WLS types .... quite frankly, is no excuse.  You pick the surgery you want and THEN you choose the surgeon.  it's like wanting a Toyota but going to a Honda dealer to buy your Toyota.  It doesn't work that way.

Frankly, she'd have a better chance of getting approved for a DS. Things are changing, but slowly, and a lot of insurance polices just don't cover the Sleeve yet. Also, if your mom has, or has had, a BMI of 50, the DS is more likely to give her the sort of LONG-TERM results she wants.

she has a BMI of between 35 and 40 right now. her insurance was approving VSG back then but only in people with a BMI over 50. She made the decision to have the band because of those two reasons...she didn't have a high enough BMI for sleeve and the surgeon wasn't doing it. So she let them talk her into a band. was it a mistake, for sure. I'm glad I got to learn from it but now I would just like to try and help her figure out how to fix it.