Lap band removed!

[RayLandry 18]

I am having my band revision to VGS in a couple of weeks. ON MY DIME! I guess my insurance felt that 2 WLS covered were the max! LOL Background here......Banded in 2005 ( insured), Band slipped and rebanded 2012 (insured), Revision set for 12/27 ( Out of pocket). Insurance denied because of prior surgeries. Oh well screw 'em! I'll pay for #3 my own dang self! Hopefully, with God's grace, this will be the answer!

[Jendkopp 62]

@RayLandry: you should contact Lindstrom Obesity Advocacy, they can help you appeal the denial for a few hundred dollars (instead of the thousands that surgery will cost). they will only take your appeal if they believe they can win. they helped me to get everything approved. here's there website: www.wlsappeals.com

[RayLandry 18]

Jenn, thank you for the website! Since my surgery is only about 2 weeks away, do you think it is too late?

[S@ssen@ch 745]

@RayLandry. I agree with jendkopp and I would challenge this. With your surgery 2 weeks away, the clock is ticking. Do not wait!

To me, this is clearly a failed implantable device and your insurance should have provisions for surgical correction of an implantable device (ie: revision). Think about this in terms of an artificial joint. They are known to fail sometimes, but an insurance company really shouldn't have limitations on how many surgeries you can have on your artificial joint.

Best of luck!

[RayLandry 18]

Well, I'm not sure if I am throwing good money after bad, but I just enlisted Lindstrom Obesity Advocacy to for a second appeal! Thanks Jenn for the recommendation. We'll see what happens! The cost of the assistance and advocacy vs. The surgery costs......well, it's a no brainer! I just hope that I didn't dig myself a deeper hole!

Thanks ya'll

[Jendkopp 62]

@RayLandry: keep us updated on your appeal. Good luck!

[of 0]

I had my band removed as well with insurance covering it. Medical complications do meet the criteria to remove band and have another wls. Find out what the requirements are... “medical reasons for removal “

Reflux chronic acid problems upset stomach. Bad heartburn ect. You get the drift.....

[RayLandry 18]

fingers are crossed!

[kerrik54304 34]

Do you think insurance will cover removal and conversion surgery if I am no longer obese? I would like to remove the band that I had put in almost 10 years ago, but am at a healthy weight. I feel like it is a ticking time bomb. I do have problems with acid reflux and food getting stuck if I’m not careful. I’m afraid if I just get it removed I will gain all of my weight back.

[RayLandry 18]

Like most things, you just never know until you try. I just self paid for my revision because my insurance denied removal and revision. They deemed it “medically unnecessary “. I am on my second appeal, with the help of an outside advocacy firm. I am praying this works to get me reimbursed! I too had the problems of reflux, pain, and night coughs. As a result, my esophagus was getting irritated. I am 18 days out from revision surgery and I feel great! Reflux is gone and I have already lost about 26 lbs! My BMI, at time of surgery was about 33. Not your typical 40+, like most bariatric surgery candidates. Good luck to you Kerri, hopefully you can get your insurance to pay for it! Believe me, I know firsthand, the negative outcomes of lapband!

Edited January 13, 2019 by RayLandry

[kerrik54304 34]

Thanks for your reply. Glad things are going well for you after your surgery. I guess my first step is to make an appointment with a surgeon in the area. Fingers crossed that you get your expenses covered. That’s a lot of hoops to jump through to get your health back on track.