I need revision

Well I just found out Friday that my surgeon wants to revise my sleeve to RNY due to extreme reflux (I can't keep my food down most of the time).  I was just looking at my policy and I do not have WLS benefit.  Is there anything that I or my surgeon can do to get this covered?  Has anyone else had this problem?  I will change jobs if I have to it is that bad!  Thank you for any help

Does your policy say the words "exclusion" ? If so then I'm afraid you have no chance to get them to cover it. This is what I was told by 2 dr offices. 

Im so sorry you are suffering with such reflux. My heart goes out to you . I was just revised from band to rny. If your policy doesn't say the word exclusion.... I'd think you have a chance . I got 3 denials then finally approved . 

I would call the number on your insurance card and ask them to connect you with the bariatric coordinator of they have one, otherwise ask them to explain your benefits regarding weight loss surgery 

good luck 

I had the band removed 2/29/16 due to severe complications. Insurance initially denial stage two revision to rny but external appeal ruled against them and approved the procedure. I'm a little concerned about it after reading about the complications    What was your experience with the rny ? Any complications? Thanks 

I had zero complications. I am 4 weeks out and have had nothing but relief. I can eat and drink better than with a band and am very pleased. I was completely anti rny for fear of complications. I honestly believe many many many more people have no complications as people that do. Good luck with your decision. If you go on over and stalk the gastric bypass boards you will find that 99% of rny patients there only regret not doing it sooner. 

My weight loss is slower than some, 12 lbs this month. But I'm a revision and also I'm considered a light weight. I'm here if you have any questions I can help you with . Again go to the rny gastric bypass boards . There are a lot of helpful people that will share 

 Thank you. I was told the same by several people however there are a handful of blogs that have people with complications.  Many probably did not follow the rules ie vitamins and supplements  I've had the band for 8 years. No problems for six lost 130 pds. Two years ago port got infected and the nightmare began culminating with gastris  multiple ulcers  dialated esophagus and loss of ability to swallow  and erosion. That's why I'm looking for a sustainable solution. The band was removed in February . The boards also reflect a lot of sleeve to bypass revisions. Once again Thank you

Sorry one last question.  Do you have to take lubinox shots every day for a few months (to prevent clotting).  That's what my surgeon mentioned.  Thanks

No . They gave me heparin in the preop waiting room

and then 2 shots a day while I was in the hospital. Every surgeon is different though and I don't think the lovinox is a bad idea . 

You are welcome. It sounds a lot like my story and good luck in your journey. It helps a lot to stay on here for support . 

Hi Steven.  Did your insurance have an exclusion or just denied the first time around?

My insurance did not have an exclusion but contained the clause " for a revision you must have a bmi of 40 or co morbid condition like sleep apnea or heart attack" my bmi was under 30  but have had 8 successful years until band failure.      after two appeals external review board ruled in my favor.  I'm in ny and have oxford