sad....

free4l1fe
on 1/6/12 2:00 pm - University Place, WA
REALIZE Band on 03/27/12
 So, I went to my surgeon today in hopes there was a way to get my insurance to cover the sleeve instead of the bypass (which my insurance does cover). But to my great disapointment, he said there is nothing we can do. I really don't want the bypass. So now I am going to try and find a private insurance that will cover it. Has anyone here experianced the same sort of thing?  I'm looking for some kind of direction. If anyone has any ideas, please please let me know.

Thanks!
loser2be
on 1/6/12 2:14 pm - CA
VSG on 03/02/12
 I originally had set up for the bypass and changed to the sleeve.  My surgeons office said it was as simple as changing a code.   Call your insurance directly.
free4l1fe
on 1/6/12 2:31 pm - University Place, WA
REALIZE Band on 03/27/12
 I called my insurance today, they will only cover  the band, or bypass :( it doesn't make any sense to me that they would cover one but not the other.
tall_not_venti
on 1/6/12 3:49 pm
VSG on 02/23/12
 fwiw, my understanding is that many insurances don't cover the sleeve because medicare/medicaid don't yet cover them, but in Dec they started a six month review process. We may have better coverage for the sleeve later this year....that is, IF your insurance covers WLS at all. I have great insurance, with a total WLS exclusion, so selfpay it is. 
VeronicaJ5
on 1/6/12 4:03 pm - Albany, NY
DS on 07/05/16
Medicare/medicaid still considers it investigational/experimental it hasn't passed all phases of the trails yet through the government once it does the other insurances carriers (the few left) will cover it
free4l1fe
on 1/6/12 4:09 pm - University Place, WA
REALIZE Band on 03/27/12
 well that sounds very promising. hopefully I can get it covered by the end of the year.....siigghhh waiting is not my strongest attribute :)
xxkrazytracy64
on 1/6/12 9:20 pm
hiya free, just wanted to add my 2 cents, im in west michigan,have medicade and they payed for my sleeve, my wls surgeon went in to do the rny, found out it wouldnt work for me while i was in the middle of surgery, so my doc decited to do the sleeve, best thing that ever happened to me, the insurance companys and medicade need to realize that the sleeve is the best wls out there, after being with my sleeve for the past 3yrs id do it all again in a heartbeat if needed, so i guess you could say i got lucky in the long run...i know this doesnt help your problem but thought id u my story........take care, best of luck......tracy.
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UnRuli
on 1/8/12 2:52 am - Plainwell, MI
 And I bet you got a GREAT sleeve too!  Dr. Foote does very good sleeves.


SleeveRockn Chic
on 1/8/12 1:51 am
 Just wanted to that my sleeve was fully covered by medicaid. They approved it as an outpatient procedure.  I had it done on monday and was home tuesday afternoon.  Good luck in your journey. Kerry

LilySlim Weight loss tickers  
 HW: 365lbs.  SW:353  CW:182.4  GW:160 lbs.
Goal 1: Get under 300 (Reached as of 11/15/2011 299.4 Baby) 
Goal 2- Get under 200 (Reached as of 08/29/2012 199.2 Baby) 
Goal 3- Get to 160
    

sunnymicki
on 1/8/12 2:19 am
You might also consider interviewing surgeons to try to find one who is willing to appeal to your insurance company to try to get the sleeve covered for you.  I have seen people be successful with this in the past, but it takes a surgeon who is willing to put forth the effort.  There are medical reasons you would need a sleeve rather than bypass - the ability to continue to take certain medications, a family history of stomach cancer or ulcers, etc.  I think if you search the boards for "VSG appeal" you might get more helpful info on this.

5'9" All weight lost post-op. Goal weight determined by body composition testing.

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