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Change to sleeve after ins. approval for band?

Hi Everyone,

Sorry if there are other posts about this. I've tried using the search feature but haven't found any similar threads.

Like many others, I was originally set on lap-band surgery. I went to my consultation, the surgeon said I was a good candidate and it looks as though my insurance will be approving the procedure (I have Federal BCBS).

I starting reading more and more stories about complications after lap-band surgery, I really thought hard about all the doctors visits for fills and unfills, and not to mention all the extra expense of it all (time away from work, $ for the appointments, $ for gas, etc.). After researching and talking to more people about VSG, I really think it would be a better option for me.

My question, then, is if I get insurance approval for lap-band surgery, would another request need to be made specifically for the VSG? To complicate it further, the surgeon who was going to do my lap-band doesn't perform VSG so I will have to change surgeons. Has anyone else gone through this? I am curious about the process and all that is involved with switching procedures (and surgeons) after insurance approval.

Thanks!!

~Laura

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I got a confirmation over the phone today that I was approved for the lap-band surgery. Maybe once I get the approval letter I will have a better understanding of whether I can switch to VSG with a new surgeon!

My understanding is that you have to have approval for each surgery. Many surgeons just ask for approval on all at the same time (mine did). I was approved for lap-band/RNY and denied VSG, so I appealed. I would visit some seminars and research surgeons.

I would at least try and see if you can get the sleeve (speaking from a patient who did not have success with my band and is in the process of revision). Some insurances still consider the sleeve "exploratory" so you need to get a copy of your insurance details for bariatric surgery. Good luck!

  • Author

Thanks for the suggestions! Hopefully I will get the official approval letter in the mail soon so I can chat with the other surgeon on Monday!

I have BCBS California, and I was originally approved for the band. Just like you, I decided to switch to the sleeve after my initial consultation and reading the boards. I asked customer service at BCBS if I needed a different approval, and I was told that WLS is WLS, and the original paperwork would be fine. Since, I have an HMO, but medical group had the final say and after thinking everthing was going smoothly, I found out had to get reapproved for VSG. Then, I was denied for VSG, but my surgeon's office submitted an appeal for me directly to BCBS, and after a few more weeks of waiting, my surgery was approved! I could have saved a month or two if I had straightened out the paperwork sooner, but everything happens for a reason. Hope your approval sails through the process!

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