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Wednesday, May 20, 2015

Please advise...

I was officially turned down for the revision to the sleeve.  This is the second time.  I believe my surgeon's office appealed because they told me that Dr. Mattar had a video conference with the insurance company doctor. 

They did approve removing the Lap Band.

The reason the insurance company gave is that basically I am just too healthy.  I have no health problems and my BMI is normal.

Duh, BECAUSE I have a Lap Band!

I am also expecting my insurance to change at the end of next month and I don't know if it will cover Bariatric.  Right now the surgery would not cost me very much, but that is an unknown if I wait and have it with another company.  I also may have to repeat all of the pre-op requirements, but there is a chance that the new insurance would approve the revision.

I am not having any symptoms at all of the band slip, although after it was repositioned, I had a lot of symptoms for several weeks.  The UGI identified the slippage.  With the previous slippage, I had no symptoms except smelly belching (sexy, I know), but apparently my stomach was in pretty bad shape at that time.  I don't know how significant the slip is this time around.

Part of me wants to just wait and see what happens, especially because I do not have anymore paid time off except for my planned summer vacation this year.  But a part of me thinks that is a really bad idea and I don't know what to do.

So please tell me what you guys think.  I'm really uncertain.     


Caroline said...

How frustrating! I am so sorry to hear that you were denied again :( This is a big decision and totally up to you! On one hand, it can be better to get it all done in one shabam, but then again, my recovery at first was a bit rough (4 days in hospital) because I had it removed and the sleeve at the same time. On the other hand, if you get it removed now, it won't slip and you won't experience any more issues related to the band (but will have to maintain weight completely on your own). Re-doing pre-op requirements is a pain in the ass (I had to do it for revision) but if the new insurance may cover it, perhaps worth it? It is a lot to think about. Have you talked to your bariatric surgeon/doc to see what he recommends? Rooting for you.. let us know what you decide!

Amanda Kiska said...

I have an appointment with my surgeon next Thursday. It is technically my pre-op appointment for the removal.

I also talked to the insurance qualification liaison in the surgeon's office and she said that in her experience I wouldn't be approved with ANY insurance company for a revision because I am a normal BMI and have no comorbidities.

FritoBandito said...

I don't have any advice for you. I'm sorry you are going through this...I'm sure it is so scary.

Bonnie said...

Sorry I don't have any advice either. It is unfortunate that insurance companies can't see the forest through the trees, but they just don't get it.