Question:
Has anyone with Kaiser insurance been approved for duodonal switch, or even a lap RN
someone asked this question a few months ago, but there seemed to be some new info on the horizon!!! any news???? — Maureen L. (posted on June 7, 2000)
June 8, 2000
I am approved for the RNY surgery and will be having it June 22. I met a
lady who will be having the RNY Lap. and we are both covered by Kaiser. It
takes a lot of hoops, but it can be done.
— Teresa O.
July 17, 2000
Your WLS approval process through Kaiser will depend entirely on which
Kaiser "region" you are in. I am in Kaiser NW, which covers
Oregon, Washington and part of Idaho. I am also familiar with WLS
requirements for Kaiser N and S CA. All three have a specific list of
requirements that you must do/pass in order to be approved, and each
region's list, or "protocol" is different. Now, as for the
surgery. Kaiser N and S CA both refer you out to a bariatric surgeon in
the community (from a list, not just anyone) to have the surgery. As far
as I know, no DS surgeons are on the Kaiser list. The two big places for
Kaiser S CA referrals are UCLA and Pacific Bariatrics, in San Diego.
Neither does the DS. But there is a system for requesting that a surgeon
be put on their referral list, which I am trying to do right now for the
two DS surgeons in S CA, Anthone and Crookes at USC. As for Kaiser NW,
they do NOT refer you out once approved; you still will be cut by a Kaiser
surgeon. The two surgeons currently
doing WLS do only the RNY, though one even does it lap. I am working with
Welker at OHSU to get Kaiser interested in the DS. He believes we have
been successful and that Kaiser NW will finally be offering bariatric
patients the DS as well as the proximal RNY starting as soon as this fall.
I'll believe it when I see it. As for me, I am moving from OR to CA and
don't even know if Kaiser will end up covering my surgery, even though I
have spent the past nine months in appeals to finally be approved last
month. I will end up either having the surgery in CA or up here in a
Kaiser hospital, with Kaiser personnel, and with Welker performing only as
a "consultant". Of course, if they take long enough I may have
to get approved again through my new CA insurance and do it all over again.
I will never sign up with Kaiser again!
— Jill H.
June 26, 2003
I have Kaiser Northern CA and had surgery 5/5/03. I had the laproscopic
procedure and was very thankful I did. A lot less recovery time.
www.diaryofafatlady.com
— Julie B.
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