lap bander wants gastric bypass ins. pay?

brandyII · 04-02-2008, 04:21 PM

Has anyone had a situation where they were able to get their lap band removed and also had the gastric bypass surgery and have gotten their insurance company to pay for it?

If so did you have special criteria for that coverage/surgery?

Any details would be helpful, thanks brandyII.

oreokitty · 04-02-2008, 05:17 PM

I think I heard if tehre was complacations some ins may consider it

WHY would you want your Lap Band removed??

I love mine it is my best friend.
IT still allows me to eat to much but it is working.

brandyII · 04-02-2008, 05:39 PM

Well, the truth is that I've some problems since I've had the lap band and it doesn't seem to be working for me and I might need the extra help you get from gastric bypass with the malaobsorption (sp) part etc... I was scheduled to get the bypass but chickened out at the last minute and got the lap band instead. Does that make sense? I'm happy it's working for you but it just really hasn't for me and I'm sure there are some of us out there that it just doesn't work out for. Thanks, brandyII.

favorite · 04-02-2008, 07:36 PM

have you had any adjustments to your band? with the restriction that i have i couldn't imagine someones not working if its filled to the right point. what i'm trying to say is dont opt for the bypass without giving the band a fair chance.

brandyII · 04-02-2008, 08:02 PM

Favorite,

first three months they didn't really fill it at all because they thought that it was a small band and I had the large and so being my only experience it was a bit confusing to me.

Then I got a fill from the surgeon and it seemed fairly tight and I got to know what it was like to eat the protein and vomit if it wasn't chewed enough or if I didn't eat slow enough.

Then went back for another fill because I was still gaining weight and then two weeks later got another fill and was mistaken given more than they had thought and was vomiting my own saliva for 10 hours until I met a surgeon on call to get two cc's removed.

Now I'm at 4 ccs and can feel full and will walk on the treadmill but am still not losing weight and it's been 8 months and I don't know how many more adjustments I need or months I need to wait to get it right.

I may never get it right but I still haven't given up completely yet but would still like to know my options, thanks brandyII.

Hastings · 04-03-2008, 07:34 AM

To be fair to BrandyII she has posted extensively about her problems with the band.

This forum is for support of those who want their band removed or need it removed.

It's a good thing to know your options, BrandyII. I don't have that answer for you, though. Hang in there.

KarenB · 04-10-2008, 09:46 AM

Brandy, I was approved for revision to RNY--my BMI was over 35 w/co-morbidities. A lot depends on your surgeon's office & how they present it to the insurance company.

good luck,

brandyII · 04-10-2008, 11:21 AM

KarenB, that's wonderful, I'm very happy for you. I don't know what's wrong with me, I keep trying but nothing seems to be moving as you'll see by my ticker. And at this point I only wanted to get down to 200 lbs! Good luck to you and I see my surgeon in 12 days so I'll talk to him about it. Thanks again, brandyII

Brittwoman · 04-12-2008, 07:14 PM

I was approved for my revison from band to RNY. I had to have my band removed after 3 1/2 years due to a slip and erotion

I have to mention that the insurance company made me do ALL of the testing all over again, just like a "newbie". My BMI @ the time of my revision was 36 and I had only 1 comorbidity...asthma. Best of luck to you on whatever you decide to do!

brandyII · 04-12-2008, 09:44 PM

Brittwoman,

Good for you, looks like it helped you out a lot too. It sounds promising. I could deal with going through all the jumps and hoops again, I know that's a pain thought. I still have sleep apnea and diabetes II so we'll see what happens next appointment with my doctor, thanks for your input, brandyII.

FairyFacade · 04-13-2008, 12:26 AM

The best answer to this question... call your insurance & ask :o)
You'd be surprised at how quickly they can answer those questions, they pull your policy up and tell you yes or no.

brandyII · 04-13-2008, 12:24 PM

FairyFacade,

I know that seems obvious but I kind of don't want them to know yet before I get approval from the doctor. That's why I've been trying to get feedback from people who have. Thanks brandyII.

sweetviolet · 04-15-2008, 01:28 PM

I have HMOI and I had a Lap Band removal on nov 27 and immediately had RNY...I had a dialated esophagus that would have caused permanent damage if not corrected--I cryied about it and was scared to death that I would die w/ RNY--not only did I not die but it was like I never had a problem right from the start!! I wish since I have had both, that I could have eliminated all the trouble I had w/ the band and done RNY in the first place!! I lost most of my weight w/the band, but I have now maintained easily w/RNY and can eat most anything...but still go by the band rules and am careful!! Because of other health issues I only swim for exercise...and it is VERY hard for me to get to the pool--something always seems to get in the way...like a stent on March 17...who knew!! However, if I had not lost 141# the stent would not have been possible and I would be DEAD...95 percent blockage in the anterior left atery of the heart!! Life is not over if you lose the band--only if you give up!! As for the insurance, the doctor does not make this decision to pay--only the wording to help get the job done. You can call the insurance company with a query and not give your name and ask the question!! I fortunately did not have to jump through any more hoops to have a conversion...no questions asked, it was an EMERGENCY as I could not get food down or back up and the surgery was done at night time...got to my room from recovery at midnight...went home the next day as though nothing had happened--no shoulder pain/gas/etc...I called the Doctor to see if he really had done the conversion!! Only thing now is I don't think I can look at another cup of creamed soup of any kink for the rest of my natural life!! If anyone cares to further discuss this, just pm me...I don't come to this board very often anymore...while I would like to be supportive to anyone who need it, I am in a good place and don't think too much about anything except getting on with the routine of life...what a change!!

Mert · 08-17-2008, 09:53 PM

I am looking into band removal and an additional surgery. I have had the band now for two years and have only lost about 5-10 lbs. I was asked to consider the gastric bypass from the beginning but I wanted the less invasive. Now I know they were right. I should have had the bypass. I throw up a lot, so I know I don't need a fill. I have a 10ccVG band. Sweets are my nemisis. If I could avoid them I would not be in the fix I am in still today. My BMI is about 50 and I have sleep apnea. I have not asked the insurance company I have now b/c they do not cover bariatric.

Nanook · 08-17-2008, 10:09 PM

Mert,

Good luck, my daughter had the RNY the end of May of this year and since April she's lost over 100 lbs. It hasn't been easy though as she spent most of last week in the hospital due to a stricture of her stoma and needed it dilated and be pumped full of IVs because of the dehydration.

I don't think I will revise as I've kind of lost faith in WLS, my personal thing, but read as much as you can on it because it's definitely a different ball game when you're talking about going from lap band to RNY. My daugher may have malabsorption on her side but she is very disciplined with what she eats which is not something she got from me. Well maybe I was too 30 years ago, LOL. Take care Nancy.