Looking for advice for a banded friend

Hi All,

I just got back from the bar (hey, it's St. Patrick's Day!) where I ran into a friend who has had the band for some time, but isn't happy with it and wants it out... but her insurance won't pay for a removal without a medical necessity.  She''s not having problems with it per se, but she's just really not happy with how it feels, and it just hasn't worked out the way she hoped it would.

As we were talking, I wondered if anyone here has been in a similar situation, but got approval because instead of just having the band removed, you revised to another WLS method because the band wasn't working out for you?  If her weight/BMI hasn't fluctuated much since she got the band, could that be enough for the insurance company to approve a revision to say, the sleeve?

Thanks in advance for any stories, advice, etc!

As far as that there is a huge variation as far as insurance companies and their requirements for that.

One lady posted on the band forum about 4 or 5 mos. ago that her insurance woulsn't pay for the removal unless it was an emergency and medically necessary. I think she had been sick and coughing and throwing up that day and she posted that she was hoping for a slip so the insurance would cover the removal of her nighmare band. Well the ppl on the band forum didn't like that so they trashed her! Longggggggggggg post! They really tore into her. Some ppl can be very viscious!

Here the poor woman was desperate b/c she couldn't pay to have it removed..............and hoping that it caused a slip b/c that is the only way she would be able to get it removed. And instead of sympathizing with the poor lady.................THEY TRASHED HER! :-(

So long story short..............if she gets sick and has that happen and gets a slip.............she may be able to get it removed then.................PUT DON'T POST THAT **** ON THE BAND FORUM!

my insurance wouldn't pay for just a removal, but would pay for a revisional surgery, so it might be something to look at. My revision has saved my life. SUgar a thing of the past. High bp another thing of the past. And sleep apnea CURED!

teri

Insurance policies are so individual.  She should call up her insurance and inquire.  Most times, there needs to be some sort of complication like a slip or dilation . . . . maybe reflux (could get dangerous).  Has she had a UGI to actually see what is going on with her band?  Something may actually be wrong.

Best,
Leila

there are many insurance co policies out there, but there are no insurance co policies that will remove a band just because a patient doesn't want it in there anymore, in other words, without medical necessity,  that is pretty standard for all disease states etc.  some insurance co has a 1 surgery clause, if that is the case she has exhausted that. insurance companies are discouraging the revision of wls so patients really have to be sure of the wls that they pick.   the specific insurance policy would have to be checked as they are all different even if it is the same insurance name, individual polices vary vastly. 

I agree there are so many policies it is hard to say if they will cover it.  Some insurance companies are adding a once in a lifetime weight loss surgery clause.  I just wish the lapband companies would be honest about all the problems their product causes.