LapBand to RNY insurance exclusion

HondaRN12
on 2/18/14 9:48 am - MN

Wondering if anyone can give any advice.  I currently have a lap band that was placed in April of 2009, had a port revision in 2011, and hasn't been the same since.  Now requesting conversion to RNY only to find out that second surgeries are excluded from my insurance plan.

I am appealing their decision, but I have a feeling it will still be denied, anyone have experience with getting it approved??  Any advice would be helpful!

Sherrie P.
on 2/18/14 11:11 am
RNY on 02/06/13

It is probably going to be very difficult to do since it is a written and specific exclusion. 

My policy did not have that exclusion. If they had denied me I was planning to go to Mexico.  Ready4aChange will revise from band to sleeve for $5500 - last I was quoted. 

I hated the CrapBand with a flaming passion... good luck to you!!!

Revision Lapband to RNY 2-6-2013   HW: 286  Pre-Op Diet: 277  Surgery Day: 265  Goal: 155  CW: 155

Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.

Plastic surgery 1/27/2015: Butt Lift

    

ceedott
on 2/20/14 1:06 am - PA

WHAT KIND OF INSURANCE DO YOU HAVE? AND WHAT KIND OF PROBLEMS ARE YOU HAVING WITH THE BAND?

pineview01
on 2/21/14 8:54 am - Davison, MI

As you already had one mechanical problem with the band your chances are better.  I had the 2nd surgery exclusion also but, was able to win.  The name of the game is documentation.  I had 9 months of having fluid removed as the band got tighter and tighter from scare tissue under it.  I had documentation showing I did well the first year until needing a total until.  Than a year later the same thing.

Due to the medical issues, they agreed to remove the band.  Than with all my documentations, surgical notes showing the stomach after the band was removed, I was able to prove compliance and medical problems from the band I was given a second chance and the sleeve.

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

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