If I do get approved by my insurance, they will only do lapband and roux en y surgery. I am so bummed because all the research I have done lead me to a sleeve.

Idk what it is but I am kind of scared of the roux, gotta somehow wrap my head around this.

Hehehe, not sure what I am asking here at all. I guess some words of advice!

Sorry to hear this! From what I've read, many insurances are converting to accepting the sleeve option. I suggest you try to find out if accepting the sleeve is in the decision process.

When the insurance lady at the hospital ran my insurance through they would only approve for the roux and lapband. Then she said they don't do lapbands there, which wouldn't have been my second choice anyways.

Have your surgeon's patient coordinator / navigator call the insurance company. Those conversations are often much more productive than the ones you or I could have with our insurance company.

Do more investigating before deciding against roux-en-y. I know lots of people who have had this surgery and been very successful with it. There are several at my WLS support group meetings and they are all doing fantastic. There's a reason it's considered the "gold standard" weight loss surgery! See if you can go to some support group meetings and talk with some post-op patients. They may help put any fears you have to rest.

Call the insurance company yourself. The Sleeve is an accepted weight loss procedure. Chances are they will ok it soon. If not, write a (nice) letter of complaint to the insurance company and to your employer. Good Luck!

I can only talk of the band.. but if I was to do it again, I would go rny in a second.. Good luck to you!

Don't completely rule out RNY without doing your research. There is a reason why most insurance companies approve this surgery for obesity. I was very concerned myself when it was recommended for me to have RNY instead of the sleeve. I had diabetes, reflux, high blood pressure and apnea. I went with RNY because the research told me it was very likely that it would resolve my reflux where the sleeve could/would make refluz worse.

All of my comorbidities have resolved and I feel great.

Before you decide please do your research. I would hate to see you end up having one surgery only to have a revision later.

If you feel that the sleeve is the best option for you, don't give up the fight. Speak with your insurance company directly. Find out why they aren't approving the sleeve. If your doctor agrees that the sleeve is what's best for you, have them write a letter of medical necessity, explaining why the sleeve is in your best medical interest.

Don't become discouraged. Become a fighter! This is your life, and your body. Fight for what you believe is the right thing for you.

I was going to say what others have said. RnY has a really long and good track record. I love my sleeve, but I went back and forth between the two. I'd hang out on their boards for a bit to see what's going on there, too. Also, one of the biggest upsides to the RnY is the larger average percentage of excess weight lost. It may not be as bad as you think. Good luck in whatever you decide to do!

My insurance said the same thing but my doctor stepped in and did a peer to peer. I have chronic head/neck issues and have to have the option of anti- inflammatory meds. I have also had a TIA and will be on aspirin forever. If you have anything that requires those meds, they may be able to help get the sleeve approved. I am so glad I had the sleeve done. I am 2 months out and feel really good. It wasn't a cake walk for sure but I'd do it again in a heartbeat.

they will only do lapband and roux en y surgery. research I have done lead me to a sleeve.

@@TatorTot

Appeal Appeal Appeal

you might have lost the battle, but not the war

the sleeve used to be referred to as experimental, not that many cases were done - not many stats

sleeve is NOT considered experimental by many ins companies (even medicaRE)

long term results are still not that prominent YET with the sleeve

but insurance companies are accepting the sleeve more and more

don't give up so quickly

good luck bud

kathy

Edited February 17, 201511 yr by proudgrammy