mila1013

I have bcbs also, they are the worse for getting an appeals overturned and they are notorious for that crap, deny one reason, overturn that, then deny on another reason, then deny some other reason and deny that, they are really really awful. it is at best deplorable

it really depends on your band issues, if you are not vomiting, etc then it can be done in one surgery, if not then you have to have the band out first -wait and heal then get the sleeve-that is the boat i am in...

exactly, they say that the sleeve is experimental, the 50 bmi requriement is a requirement of DS and not the sleeve as they have no requiremnts for that as they consider it investigational, i too agree since 2 major insurance co aetna and cigna are covering it, it will only be a matter of time till others jump on, like they did with the lap band-depending on how long that is, i may be joining you overseas....

Lisa, most insurance co have that bmi requirement is usually for the DS not the stand alone part of that procedure the sleeve. they don't pay for the sleeve here either, and no one knows about it, my wls has only done one, there is not need to tell your surgeon until you have made the decision to go and then it is up to you if you would like them to support you when you are back home. why not try to get it appealed through the insurance co here?

my surgeon has only done one sleeve as most people here have bcbs and they do not cover it, with my denial and appeal (if it happens) this surgeon while only doing one sleeve has done hundreds and hundreds of rny for more than 10 years and has done banding for over 7, but who knows how many he will have done in the months it will take me to go through the appeals process....

I am going to assume you were denied for the sleeve? Denial for the sleeve has nothing to do with band complications. Band complications like erosion, slippage are medically necessary and do not require pre authorization as they can be life threatening

hi all, I am new today, so I am still trying to navigate my way around the site, so please forgive me if I mess up. I am going into my 8th year with the band. last year started to have major problems, band replace in April 2010 and hiatal hernial repaired at the same time, unfortunely my damage is too severe and the band has to be removed (warning on allergan's package also) I have pseudoachlachia, dysmotility, megaesophagus, erosion I loved my band, I was 300lbs got down to 126, now with all the issues since last year, reoperation, (band is empty and will not be filled, just waiting to removed and pick a different surgery) I am up to 190 -very difficult. thanks

I was wondering how people who had this procedure were doing overall? I am new today, just signed on to this site, any help would be greatly appreciated as I attempt to navigate the site---