Lap Band to RNY?

Diane W.
on 12/26/11 2:40 pm
Revision on 08/10/12
I had a lap band in 2009 and have lost only 89 pounds.  In the meantime my Dr. overfilled me (didn't have fluoro).  I've had terrible problems with reflux and after changing Dr. found out I have a large hiatal hernia as well as my pouch was above my diaphram.  I'm now unfilled and doing well physically, but I'm hungry all the time, and trying to diet.  We all know how well that works! I don't know whether my insurance will pay for a revision, they covered my lapband, but the only other surgery they cover is the RNY.   Any thoughts?  I have BCBS...
shele
on 12/26/11 9:24 pm

Please keep researching, I believe it has been discovered that if your ins covers wls, it can be persuaded to cover the ds.

Look through old posts to see what others have had to do to get it covered.

Best of luck!

 

shele
LiFeLoNg hEaLtH imY GoAl
RNY 5-11-04 280
Lowest weight 174
Highest re-gain 238

erny 3-23-09 (120 common channel

low post revision 190
Current Weight  204

Height 5'6"

GOAL 154 Normal BMI

        
jess0308
on 12/26/11 10:14 pm - Blountsville, AL
I too, had a band in 2009, I lost 70lbs. On Nov. 28th I revised to the RNY,  one month out and loving it! I have BCBS, but mine is Blue Advantage for Medicare disability, so there may be a difference, but it is worth trying for. I was appoved in two weeks after first request.
FLJeepGirl
on 12/28/11 12:33 am
I had my band placed in 2008 and lost 60 pounds in a year, gained back all plus 20 within three years.  Ended up with severe Gerd and reflux issues.  I have BCBS and they covered my revision surgery.  I had BCBS FEP for my band and changed insurance plans (job change) to BCBS of Texas and they covered all but $1,200 for my revision.  I've found in researching, that if your doctor writes it up as a medical necessity that you have a better chance of getting it approved.  If denied, appeal...

I'm down almost 65 pounds since my revision in August.  I have had zero issues, post-recover - had open surgery, with my revision.  I'm now eating normally and no longer have the complications and the pain that I had with the band (from day one).  Best decision I ever made!   My only regret is not doing this to begin with...Research and find out what is best for you and talk to your doctor.
(deactivated member)
on 4/16/12 4:48 am - Bay City, MI
Thanks for sharing. I'm switching in 9 days. I'm so nervous! Way over the band! Ready for a new journey!
Barb H.
on 12/28/11 2:51 pm - Kailua-Kona, HI
Revision on 01/25/12
I have a similar story to those above and have been approved for revision from the band to RNY. January 25 is my day!!! I have a different insurance company from what I had with the band but was able to get it approved. When I was looking at which surgery to revise to, I initially wanted the sleeve but because my metabolism is so slow, I decided to go with RNY. There are good arguments for DS as well, but my surgeon doesn't do it and my insurance doesn't cover it. I feel comfortable with RNY so I have decided to not pursue DS. Just do your research, continue to ask questions here and of your medical professionals and you will make the decision that is right for you.
Lap band 03/09; revised to RNY 01/12
Read about my journey at www.journeyofafatwoman.wordpress.com
   
drjellick
on 1/2/12 8:07 pm - Lemont Furnace, PA
I also had band done on 4/2009  found out in July 2010 that my band slipped down not up.  My surgeon recommended that I have it removed.  Had a EDG done in Oct. to see if it has eroded into my stomach.  Thank God it did not, but did find that my GERD was alot worse than what I thought.
My doc recommended the RNY and wrote it up as something medically necessary due to the GERD.  I was denied the first request because my insurance BC/BS PA said it will only pay for 1 weight loss surgery a lifetime.  But my doctor went to bat for meshe told me don't be surprised if it don't hit the fan fast   and within 2 wks I was approved and had my surgery Nov 25.  It was the best thing I did.  I have had no pain at
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