Lap Band Revision-Insurance only covers removal

Maggiemay44
on 11/15/17 7:26 pm

Any advice is greatly appreciated. I had the Lap Band removed in June 2017, after having for 10+ years. I had regained all the weight I originally lost, plus added an additional thirty pounds for good measure. The band had become encapsulated and was unable to be filled, among other issues.

My surgeon has been wonderful through this entire process (1.5 years). My insurance through my work has covered my office visits, upper GI, endoscopy, and the eventual band removal surgery. What I found out, is the insurance policy does not cover actual weight loss surgery. So, while they paid for the removal...that was it--no revision. This was heartbreaking and so frustrating.

My surgeon works with another hospital outside of our area that offers the VSG surgery and a year of follow-up appointments for a reasonable fee for cash patients. He is willing to travel to this hospital (his former place of employment) and perform the surgery (3 hours away) for me. I've saved for the surgery. The catch is since it is considered a revision surgery with more complications. If there were a complication how would I pay for it?

Does anyone know of a temporary emergency only insurance policy? Has anyone had to navigate this type of maze? Thank you for your help. I'm feeling so overwhelmed and disheartened.

ladygodiva1228
on 11/16/17 6:23 am - Putnam, CT
Revision on 02/04/15 with

Sorry to hear your employer does not cover WLS. Now don't quote me, but I think if there are complications that you may have to pay for them out of pocket. I do not know of any emergency only insurance polices. Hopefully someone who does know will chime in.

I also want to warn you about getting the sleeve after having the band. Now the sleeve is a great surgery, but I have seen time and time again that many previous lap band patients who get the sleeve end up having to get the bypass done due to GERD/reflux and excessive acid. I myself am a band to bypass revision. Because I had such issues with reflux/heartburn from the band that my surgeon said the sleeve would not be a good choice as it can make those symptoms worse.

Best of luck to you.

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

Maggiemay44
on 11/16/17 5:30 pm

Thank you for your response. You've given me a lot to think about and discuss with my surgeon. It looks like I have some more research to do. I really do appreciate the feedback.

Travelher
on 11/23/17 8:17 am
Revision on 10/04/16

I second LadyGodiva I chose RNY because I could not chance paying for 2 revisions...nor did I want to put myself through that. The stats between RNY and Sleeve with my doc were so similar in terms of complication rates there was no reason not to do RNY. I felt like sleeve was too much of a risk and my doctor agreed with me. it is why he suggested RNY.

Band-RNY revision age 49 5'4" HW 260 SW: 244 (bf healthy range 23-35%) bf 23.7% (at 137lbs) cw range 132-135.1st round plastics scheduled April 13, 2018

Pre-op-16lbs (size 18/20...244) M1-16lbs (size 18...228) M2-15.6lbs (size 16/18...212.4) M3-10lbs (size 16..202.4) M4-11.4lbs (size 14...191) M5-10.8lbs (size 12...180.2) M6-8.4 (size 8/10...171.8) M7-6.4 (size 8...165.4 lbs) M8-11.6 (size 6...153.8) M9-5.6 (size 4/6...148.2) M10-5.8 (size 4....142.4) M11-4 (size 2/4...138.4) Surgiversary -1 (size 2/4...137.4) M13-2.6 (size 2/4...134.8) M14 (size 2/4...134.8)

Gwen M.
on 11/19/17 4:52 pm
VSG on 03/13/14

Since this is open enrollment time, are you able to switch to a policy that DOES cover WLS? Or is this an employer restriction?

If it's an employer restriction, have you tried appealing to HR?

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Plastics with Dr. Michaels - 6/5/2017 (LBL&brachioplasty), 8/14/2017 (UBL&mastopexy), 11/6/2017 (medial leg lift)

Age 40 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

Check out my TrendWeight

MiaS
on 12/3/17 12:42 am

All the best for your upcoming surgery

I had my band removed 2 months ago due to a severe port infection. I am lucky to be alive! I have started putting weight on and would like to consider RNY as a self pay. My surgeon may or may not accept me due to my low Bmi and I have to wait till month 6 or 12. Of all the revisional procedures I have read about RNy seems best for me except I have concerns about not being able to derive enough nutrients from what I eat and also not being able to eat (I don't want a liquidised diet). My band had so many issues I spent more days that not on shakes and even then I didnt lose anything

both my band and port have gone

if the band was still there and no port perhaps I'd be ok weight wise now

LisaK/ UnstapledLisa
on 12/11/17 4:40 pm - plymouth, MN

Mia,

I am probably going to get crucified for this, but take this for what it's worth, as I only came on this thread to reply to the OP, but caught your response.

I am pro-wls and being a "grandma grad" both in the respect rny was 16 years ago, rny reversal was 7, have seen all the wls and revisions do both great and terrible things depending on the individual.

I get the desire, to want to do a rny to prevent any regain issues, but if you have low bmi, once a surgeon does a rny, they will NOT be able to predict how much weight you would lose, the same would be with any revisional surgery, except most surgeons with bandsters *****vise to rny are dealing with patients like the original poster.

I'm not a clinically trained professional, not trying to play one on here, but if you're at a low bmi now, not only could you lose more weight just from having another surgery, instead of just having to do shakes, you could end up feeding tube wise, if you got too nutritionally deficient and the nutritient deficiencies in themselves, can cause secondary irreversible complications.

Again, I'm not normally a "negative nellie" when it comes to bariatric surgery, including revisions. I think wls (all of them) can provide the morbidly to supermorbidly obese the best chance, as a last resort, to lose a lot of weight and keep it off.

But as a preventive measure from potential regain issues from a patient who's already had bariatric surgery that was problematic? No, I am not for it at all. While you may see on the revision boards where people who were thin had a low normal bmi, where their surgeons revised due to complications do well, and are gratefully posting it on here, I'm getting emailed privately due to being public about my reversal, when others need a reversal and it's almost impossible to do or even more dangerous, because they had revisions on top of revisions, while thin and it caused catastrophic and sometimes fatal outcomes.

I'd rather say that now, then you go through with a rny, should you find a surgeon who's willing to operate on you and less than a year later, you're in a terrible situation.


I've had wls peeps, because I had regain issues before and after reversal, actually tell me to my face they rather be dead than be fat again or be even my weight (I've kept off 50 of 100lbs which was my heaviest) at this point.

Bless their hearts.

And lucky for them, they've never known from what it's like to learn the hardest way possible, that not only is it possible to gain a lot of weight with complications, but it teaches you in the most horrific way possible, that's there's definitely worse things than being fat after bariatric surgery.

Most of my reversed and unbanded peeps whether they were fat or extremely thin, would rather go to life before bariatric surgery, if they could. But we can't. So I'm saying INMNSHO, it's worth the risk, if someone is really heavy and miserable to try it again, as it's supposed to be a tool, not a form of torture.

But as a preventative means, I don't think so. I begged for a revision at my heaviest before I even knew that rny could EVEN be reversed, as if I had to be that sick, I didn't want to be that heavy, so it's not like I don't get it.

My surgeon wisely told me, it wasn't worth the risk, even though I had been living and nearly dying for years. By the time I was told by my surgeon I needed a reversal to save my life and he said also wisely, that should I regain all my weight back and/or gain even more, I'd unlikely be eligible for any wls, as I was sicker than any obesity related co-morbidities, I didn't care what I weighed, I just didn't want to die an extremely painful death in 2010.

There are a zillion different types of groups for support now in the era of social media. There is for us rny reversed peeps, I'm sure there are for people who've had different experiences long term, with just being unbanded, it might help to seek support with others, who got unbanded but didn't revise.

Hopefully this helped... Sorry it was so wordy...

LisaK/ UnstapledLisa
on 12/11/17 4:45 pm - plymouth, MN

You could try alternative insurance plans like others suggested. There is also a non profit that does wls and reconstructive grants called the WLSFA. Which stands for Weight Loss Surgery Foundation of America.

I don't think I can post their website here. You can use a search engine which will bring you to their website which states exactly what you need to know to apply for a grant.

If you can't find it, feel free to email me here.

Hope this helps... Lisa

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