Hi all,

Looking into the gastric sleeve, which is what I should have done in 2010 instead of the Lap Band. My band slipped and I had surgery to correct it, but I was never able to eat without vomiting after that so I just had it removed. I lost 60 pounds successfully but the slippage and too many surgeries in a short time turned me off. Fast forward 7 years and I am almost all the way back to my heaviest weight. I am now diabetic and need to take Lipitor to manage my cholesterol. My knees hurt as well. My question is will my insurance company approve another WLS? I am 53 yrs old and will retire in 3 years. Same insurance company (united healthcare) that approved it in 2010. Has anyone run into this scenario? What were your results? Still contemplating...

If it was removed due to complications like that, and you check off all the qualifications for this one, I don't see why not. However, it's something to discuss with your PCP and maybe even call your insurance provider directly and have a discussion with them. It's not like you had it and just removed it because you 'felt like it'. It was making you sick, and that's not a way of life that anyone wants to live. One would hope that wouldn't be held against you.

It's difficult. I was banded in 09. I've kept off 50 lbs. but it's been a struggle. I have had fill put in and out so many times I can't remember. Ins will want to see compliance and if you gained that say you were not compliant. Many dr mine included are doing the sleeve for $10,000 all inclusive, hospital etc. with 3 yr follow . My ins is covering a revision but I have Years of compliance history even then it was denied at first. So ask your dr about private pay especially for revisions.

Hi just came from dr to schedule my revision. Actually he was asking me about what I sent to get them to approve. It is hard. I later was told they sen 160 pages of documentation. And yes they check off from there list. For me after the rejection and Pier review they questioned a year that I had not seen the Bariatric Dr. But I had other dr notes and pages of compliance records.

Ins may pay for removal which is easer to justify but you may have to cover revision

Was banded 2012. Now 2 days from sleeve all approved by my insurance after doc did a peer to peer.

On 3/1/2017 at 10:31 PM, Nanaoffour said:

Hi all,

Looking into the gastric sleeve, which is what I should have done in 2010 instead of the Lap Band. My band slipped and I had surgery to correct it, but I was never able to eat without vomiting after that so I just had it removed. I lost 60 pounds successfully but the slippage and too many surgeries in a short time turned me off. Fast forward 7 years and I am almost all the way back to my heaviest weight. I am now diabetic and need to take Lipitor to manage my cholesterol. My knees hurt as well. My question is will my insurance company approve another WLS? I am 53 yrs old and will retire in 3 years. Same insurance company (united healthcare) that approved it in 2010. Has anyone run into this scenario? What were your results? Still contemplating...

i was in the same exact situation. i had band removed in 2010 and just had my sleeve 8/9/17. i am 50 and had most co morbidities