sad....
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!
Thanks!
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.
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.
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
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 :)
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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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.