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Sleeve Hopeful

Hello everyone,

The sleeve is new to me. I went to see the surgeon hoping for the RNY, but was turned on to the sleeve just to be denied by my insurance. I am in the appeal process now and I am 14 days into the 30 day wait. I am anxious and nervous. I am not sure if I am still going to continue to appeal if I am denied because right now my severe back pain is a constant reminder that 29.5 years of being obese has taken it's tole!

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Featured Replies

Hello everyone,

The sleeve is new to me. I went to see the surgeon hoping for the RNY, but was turned on to the sleeve just to be denied by my insurance. I am in the appeal process now and I am 14 days into the 30 day wait. I am anxious and nervous. I am not sure if I am still going to continue to appeal if I am denied because right now my severe back pain is a constant reminder that 29.5 years of being obese has taken it's tole!

I think insurance companies are finally seeing the value in sleeves. Bands and bypass have so much aftercare and complications. They are a life long investment and the dollars will be spent forever. No so with the sleeve. So hopefully ins co's will change their tune soon.

If you have to take NSAIDs that is a contraindication for bypass, that might help with the appeal process.

You sound a lot like me. I'm waiting for a peer-to-peer review to take place. I too have back pain and take NSAIDS. But I have other reasons why the sleeve would be better for me too. Here's hoping we both get approved!

  • Author
I think insurance companies are finally seeing the value in sleeves. Bands and bypass have so much aftercare and complications. They are a life long investment and the dollars will be spent forever. No so with the sleeve. So hopefully ins co's will change their tune soon.

If you have to take NSAIDs that is a contraindication for bypass, that might help with the appeal process.

Yes I do take NSAIDs for my back pain and I have to take Iron pills for anemia as well. I hate taking meds and really don't want a blood transfussion so I am researching every angle!

  • Author
You sound a lot like me. I'm waiting for a peer-to-peer review to take place. I too have back pain and take NSAIDS. But I have other reasons why the sleeve would be better for me too. Here's hoping we both get approved!

I have spoken with a few people that have the same insurance just different hospital. I am signing up for another seminar just in case but I am sad to say after this appeal I "probably" will not continue to appeal it.

Yes I do take NSAIDs for my back pain and I have to take Iron pills for anemia as well. I hate taking meds and really don't want a blood transfussion so I am researching every angle!

You have every reason not to get bypass. You will malabsorb iron and you have to take NSAIDs. You are already short on iron anyway.

The problem is that many ins co's say that if you can't deal with bypass than they will pay for a band.

Some docs say no to NSAIDs with a band but most say it's fine. They used to believe NSAIDs caused erosion, now they know it is not true so it's hard getting beyond that one with ins co's.

My prediction is going to be that they will understand why bypass is not possible so they will approve a band. Appeal appeal appeal!

  • Author

I was hoping my extremely high BMI 51, would help with that decision plus I have had 4 C-sections 3 horizontal and 1 vertical....

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