Will insurance cover both lap-band and revision?

Updated on October 21, 2019 in Insurance & Financing
9 on October 18, 2019

How likely is it for an insurance company to cover both the lap-band procedure and the revision should the band fail to work?  I can read my own policy, but I’m planning to switch jobs within the next year, so it’s more of a general question.  I was approved for a sleeve procedure, but I decided to switch to the band because it isn’t permanent.  I’m in the process of getting the change approved.  I hope the band works for me and I think it will, but I want to know about the revision just in case something goes wrong. 

 
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0 on October 19, 2019

I could be wrong, but I don’t believe most insurance plans cover weight-loss surgery.  Some plans cover lap-band adjustments after the procedure and some do not.  It’s hard to know what the policy will say down the road.  

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1 on October 20, 2019

I think if an insurance plan covers one method, they’re likely to cover all methods of weight-loss surgery so long as they’re medially needed.  A revision might be different though.  Another poster brought up an issue that made me rethink how insurance might work with this.  Maybe some plans only cover a revision if you really need it because you’ve suffered a complication.  Some people go from a sleeve to a bypass and I wonder how insurance works in those cases too.  So just finding out whether insurance plan X covers weight-loss surgery Y might not be enough.  Maybe it’s more like – in what W instances does insurance X cover weight-loss surgery Y or revision Z.

on October 20, 2019

No…not at all the case. These plans are specific for a reason- if it’s covered, get all researchable info ,as they change yearly….and they do because it keeps the costs of what they still view as Cosmetic/elective surgery down

Please check with your providers. Please call and talk to ur insurance company.

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2 on October 20, 2019

I would NOT get the band. I can’t advocate enough for the reasons why not too, but here is a few points to think on:
Banding in theory, is sexy. U put this device in, u lose weight, and you go on with life, full stomach in future, right?

In practice, it acts like putting the patient in a cage of starvation. And, like starving an animal, when you let them off that system, weight gain, happens immediately all over again.

Sleeved patients are not typically hungry after, the area of the stomach that creates Ghrehlin is gone. No hunger. So the control is higher, banded, it’s suppressed, but not by much. Still hungry.

The other reason to not band. Look at the complications. Herniation, slippage, and ports relocating. They can literally sink into kidney and livers. They can, cause you to lose a portion of these vital organs. I’ve seen it in post op patient reports…and the part that bothers me is it’s too often.

Insurance paying for this,should not be the defining reason you have this device implanted. Insurance is in the business of keeping you rotating thru their system…and banded does gaurantee that, & success is great after, but declines rapidly past yr 5. I’ve seen and talked to patients with banding in for 20…so many health problems and the herniation so severe, that bypass in the revision, was the Only Option. They peel the tissue off the band to remove like that of Velcro. Sometimes that process, can use tissue that is needed to be Sleeved. The only option is FULL RNY, not MiniBypass , but full. RNY is a great surgery, but this jumping to bypass, is the end of the road, in weight loss surgery. Besides plication of the bypass, if you mess it up, not much can be done to give back stricture..and it costs the same as a full bypass if you find a surgeon willing to do this.(extended RNY)

Please don’t possibly lose the option to be Sleeved because of what that device could potentially do, to take away your chances to enjoy a life that is honestly very easy to deal with and maintain.
I know I ramble…ask me if u have questions, I’ve been up with babies all night!

on October 21, 2019

My original surgeon didn’t want to do the band because he said they had a high failure rate.  I wanted to give it a try then move onto something else if needed.  I see now that the band carries a lot of risks that I hadn’t anticipated.  Thank you for explaining things so well as I truly had no idea about the inherent risks.  

How are your babies doing?  I hope you’ve been able to get some sleep.  

on October 21, 2019

Well, that’s a post sleeve thing, my babies. I’m 43, w/ an 11yr old, a 2yr old and a 10mo old. I had PCOS, and it went away!

So now at my 43yrs, I’m doing teething and diapers all nite! But losing the weight, ditched the disease, and I’m blessed to hold my baby loves, and I am grateful for the option! Libido I men…happens pretty quick after surgery (month 4-6)…women can take a bit longer (Month 8-10) but it can be a bit like being 12 again. Expect needing a Book someplace in ur future, all over again….ohh and zits! #HormoneDumpsAreCrazy

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1 on October 20, 2019

I don’t think any insurance plans cover additional weight-loss surgery if your failure to lose weight was due to your own lifestyle choices (eating the wrong things and not exercising) AND you didn’t have a medical reason to have another surgery.  That’s something you’d have to ask your provider though.  

I’m not trying to change your decision, but are you sure you want to go the gastric banding route, Quill?  The procedure has really fallen out of favor with most bariatric surgeons because so many of patients either experience complications or they fail to keep the weight off.  Some hospitals won’t allow them to be performed.  I know you want something that isn’t permanent, but it seems no different than going on a diet which also isn’t permanent.  We’ve probably all lost weight on our own for a period of time and we’ve all gained it back. The band deteriorates with time and you can’t wear it forever. Once you have the band removed, won’t you just gain that weight back too?   A permanent change might be what you need.  

on October 21, 2019

I would tend to lend to the same as Mark. Einstein, stated: that the definition of insanity is doing same thing over and over again. When the band is removed and it DOES, have to be removed ,(about 5 yrs down the road or stuff inside starts to go bad)what do you plan to do then? Weight piled on for a reason, and IMO, this is just putting it (surgery) ultimately off to down the road, and delays you figuring out the underlying cause, why.

I do disagree here a bit with Mark. It’s not always when it’s diet, exercise, water…sometimes stress weight is a factor, disease, meds, sleep, too little calories, environment (yup, allergens can help u hold weight)but the biggest imo, is psychological triggers. I would say the best thing I learned starting before surgery if possible, is to pay attn to what is a stressing me out. That way, when you don’t have the coping mechanism with you (having removed the stomach portion) you can stop yourself from hurting, You, with food.

#TrustTheJourney

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0 on October 21, 2019

Wow, I didn’t expect to get so many informative responses.  You’ve all given me a lot to digest and I might need to reconsider the best weight-loss surgery option before moving forward.  I didn’t realize all that stuff about the band.  I just latched onto the fact that it wasn’t permanent which felt safer to me.  It looks like it can easily do permanent damage though, and it will be a hassle to maintain.  Thanks for taking the time to reply.  

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