Lost my band

 I had to have my band removed in an emergency surgery because it had slipped and was strangling my stomach. I had done really well with it, and my BMI is now 31. My surgeon has put in for revision to a vertical sleeve to my insurance, BCBS, and he doesn't think I will have a problem. The band slipped because of the angle of my stomach, I was a compliant patient. I'm just terrified I won't qualify for the revision because of my weight.  I know if I don't have the surgery, I'll just gain it all back. I'm so scared. Has anyone been in a similar cir****tance? Do you think insurance will cover it? Help?

If you get denied, than you may want to try appealing and putting in for a 2 stage revision.

I'm worried that I'm going to be in the same boat, also with BCBS (federal, in my case).  I still have my band, but I think it's slipped.  I haven't been able to see my original surgeon in over two years due to moving to the opposite side of the country.  I've got an appointment on the 25th with another surgeon, so we'll see how my band is doing.  My BMI is 32.8 right now.  My BCBS plan booklet says that for subsequent WLS, you have to meet the 35+ BMI requirements of the first surgery, plus some other requirements, but I don't know if that's true for revisions that are necessary due to band malfunction.  I've seen another person posting either here or at VST that had to have her band removed, and BCBS covered the removal but refused to cover the revision.

BLUE CROSS BLUE SHIELDS covered my RNY but did not cover the cost to remove my band when they did 1 surgery.  I am so glad I did 1 surgery though.  THANK GOD my surgeon ate the cost of removing the band and accepted what the insurance paid.  THe hospital had to eat the extra time in the operating room but it was all worth it.

IF the band is malfunctioning you do have a better chance of revision.  Just make sure they are documenting what is going on.  I had a narrow esophagus so when the band was put on my stomach the esophagus did not want to release food or liquids into the stomach.  I also had severe acid reflux but my band had not slipped.  I even had acid reflux with no fill.

TAmara

They approved my band removal that I had done on monday but they pended my sleeve for 8/22. My BMI is 32. When I spoke with insurance (the nurse) she said that it has nothing to do with weight. She said they just want to make sure that I still want the sleeve. My dr. Also needs to submit why the sleeve is necessary such as: given her history of weight gain will occur with return of co-morbids. When I saw him after surgery he said we will work out a game plan next week. He also said eat lots of protein you weren't able to with band and gain 5 lbs of muscle! I thought that was funny!
So needless to say I will be drinking lots of water before that appt!

 Thanks for taking the time to reply every one. There was no problem paying for the removal of my band since it was an emergent situation, and I had no choice in the matter. I can't have another band put in, because according to my surgeon the angles of my stomach make another slip inevitable. I'm supposed to hear from my insurance co. by Tuesday. I'm hoping that they agree to go ahead with the sleeve, even though I'm at a lower BMI cause I wouldn't have gotten there without surgery and I won't stay there long without another surgery! LOL. My surgeon didn't do a revision at the time of the emergency surgery because I was unconscious when they brought me in and he couldn't fix or replace the band  due to my anatomy. He couldn't do a different surgery without talking to me about it first. We'll see what happens-I'll let you guys know the results. Still wondering if anyone had their band removed in an emergency, and then had a sleeve approved by insurance with a low BMI?

Hi,  After 3 years, my band slipped.  I had been down to 155 for 18 months.  They fiddled around with it, trying to get it unslipped.  When they unfilled, it went back, but the instant they went to tighten again, it slipped.  So, out it came.  6 weeks later I had a VSG done.  The total time between initial slip and VSG was 6 months; I gained 45 lbs.  So yes, you do regain if you don't do another surgery.  You can't help it; your body is used to going on only 1000 cals/ day with the band.  I cannot eat only 1000 cals/day without a weight loss tool helping me.

At any rate, directly to your question, my insurance approved it after speaking with my doctor.  They wanted to be sure that it was a mechanical failure of the band, not a non-compliant patient before they approved the VSG.  Once they found that out, it went through with no problems.   I do like the VSG.  The sensation is a bit different than the band, but actually I think it's a bit more comfortable.  (I was not one of those people who hated their bands.  I loved mine --- until it slipped.)

Best of luck to you.
Eileen

I had my band(s)  removed due to irreversible medical complications via BCBS.   My bmi for the first explant was in the 20's and second explant was in the low 30's.  My final revision (4th WLS) was performed about 6 months after my 2nd explant with a bmi in the low 30's.  Everything was fully covered by insurance since it was all medically necessary.  You really need to get you subscriber agreement and your WLS policy and read them and know them well, your dr will not know you specific governing contract language.  Good luck to you in your journey for a revision...

 Thank you so much Airbender! My Dr. feels that it will be covered, as he has had other patients with BCBS with similar cir****tances who were covered. I'm feeling pretty positive, but until I have the confirmation from insurance I won't breathe easy!