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Revision from Lap Band to Gastric Bypass

hharrison43

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hharrison43    16

hharrison43
Posted

I am new to this Website and love it so far! I had a Lapband placed in May 2012 and have only lost 24 lbs! I get stuck and have one issue after another. On two different meds now for Reflux from band. I am seeing Dr. July 2nd about having Revision to Gastric Bypass. Has anyone had this done and if so what are insurance requirements? I have Tricare Reserve Select. :)

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AuriP    420

AuriP
Posted

I haven't revised yet but I have to repeat the whole process all over again. That is standard where I live, MN. My insurance is different than yours and I would look at the policy to make sure they don't have a once a lifetime bariatric surgery clause. Although I don't have the required 3-6 month diet, my insurance doesn't require it, that might be something you have to do as well. My band only provided me a 23lb loss and I frequently would get stuck, so much that I had and still do have some anxiety(unfilled) that foods will get stuck. I used to dread eating for fear of it coming back up. Hopefully your process is a smooth one.

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hharrison43    16

hharrison43
Posted

Thanks for your post and help! Hopefully Tricare won't be as strict about the second surgery. I do know they said they only pay for one weight loss surgery per lifetime, but also said hey would consider if having problems, which I am. Irisheyes72, good luck with your surgery!! Hope it all went well!! Let me know how the surgery went and keep me posted. ;)

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ferguson23024    30

ferguson23024
Posted

I had my band removed in Nov. 2013 after six years. I am having bypass on July 8. Yipppeeeeee!

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hharrison43    16

hharrison43
Posted

Yay ferguson23024!!! That is awesome news!!! What Insurance do you have? Do they have a clause in there about revisions? Tricare stated they would pay for revision if proven to be medically necessary. I go Wednesday for Consultation visit. Prayers itall works out!! July 8th is next week!!!!! EEEEKKKK!!! :D Good luck!!!!

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myusername    6

myusername
Posted

I will be having lapband to RNY surgery and I have Tricare. They initial denied my request due to the once in a lifetime thing but we appealed and were able to prove it medically necessary.

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hharrison43    16

hharrison43
Posted

That is good to hear! Congrats on your approval!! :D I had my initial consultation Wednesday and based on my BMI and Co Morbidities I qualify. I also so my liver specialist yesterday and he stated he will write a letter to include in my auth request packet stating in order to stop the progression of my liver disease it's imperative I have the revision. Fingers crossed! I have apt Aug. 8th to have EGD to ck for band erosion and also look at esophagus since I've been having horrible reflux. Also referral has been sent for Psych eval. I'm hoping I can send in enough info initially to not have to appeal. We shall see. Do you have a date set yet? :)

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ferguson23024    30

ferguson23024
Posted

I have Anthem. No problems whatsoever. I am getting nervous but so excited at the same time. Ready for a new me!

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hharrison43    16

hharrison43
Posted

Good luck to you!!! I've completed consultation and psych eval. Now just EGD on Aug 15th then they will submit to ins for approval. Fingers crossed!! :)

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weightlossdiva1234    13

weightlossdiva1234
Posted

Good luck to you!!! I've completed consultation and psych eval. Now just EGD on Aug 15th then they will submit to ins for approval. Fingers crossed!! :)

I'm 6 weeks post op and everything went really well. I feel like one of the lucky ones. I went back to work after 2 weeks. My insurance did deny me at first due to a 1x per lifetime clause but I appealed and won. Stay positive !!!

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mylossyourgain    2

mylossyourgain
Posted

I just had my Lap Band to Bypass revision on July 15. So so happy I did it and so wished I had done it in 2007 when my Lap Band was placed. Only lost 40 lbs, then gained back 20 over the years. I have BC/BS. My pre-op requirements were minimal due to the long weight history. First busy to surgeon 4/7, insurance approval first time, surgery 7/15. Just make sure you have a surgeon that writes really good letters. Best if luck to you!

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Stephanie Rodriguez68    34

Stephanie Rodriguez68
Posted

Good luck to everyone. I had my band placed in 2008. Two yrs ago I started having problems with my band being too tight (last fill 10/09), reflux, food getting stuck, weight gain, and the worst for me, the health problems I was trying to prevent by having surgery in the first place.

I am hoping to get approval for revision soon. I was self pay with band surgery, but I currently have Humana. I am scheduled for an EGD and esophageal manometry on Aug 1st. If my surgeon can find a medical reason why I need the revision my insurance will cover it.

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Go To Topic Listing Revision Weight Loss Surgery Forums (NEW!)

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      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
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    • Aunty Mamo

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      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
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    • BeanitoDiego

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      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
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    • BeanitoDiego

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    • ChunkCat

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      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
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      · 0 replies
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