Question:
Why does Guardian Ins. considers lap-band surgery, cosmetic surgery?

I spoke with someone from Guardian Insurance and they told me they consider lap-band surgery cosmetic surgery. It seems to me they need to study this proceedure more thoroughly and get with the program. Lap-band surgery is a very effective weight loss surgery.    — Margaret M. (posted on August 21, 2003)

August 21, 2003
Many insurance companies consider lap band surgery as experimental still and they do not cover it. It is still a very new surgery. Roux EN Y is considered to be the gold standard for weight loss surgeries. Hope that helps.
   — ChristineB

August 21, 2003
It has been over 2 years that the FDA approved it. Plus 13+ years outside the US. Some big experiment. The lapband is "Gold Standard" everywhere else in the world, and more and more people are choosing it here in the US. My guess is that it will be "Gold Standard" here in a couple of years. I would appeal if you were denied. Keep trying. I was self-pay when I was denied (more than once), though I was approved for the RNY. I found a way to get the band because I knew it was right for me.
   — Sheryl W.

August 21, 2003
Like the first poster said, it's experimental to many insurances. Cosmetic is a joke. Maybe the person you talked to did not know what it was and assumed it was plastic surgery. Call again. This time give them a procedure code. If it's still not covered tell them you want to see in writing where it isn't and why. <p>I have BC/BS United of WI and when I got my approval letter it said only a standard RNY or VBG was covered. No mini or long-limb RNY's. So I'm pretty sure the AGB would have not been covered too. My guess is that acceptance, by the insurance companies, of the AGB will come through faster than it will for the DS, but both are still an issue with most insurances. There have been enough done out there of either that it is time for the insurance companies to let the surgeon and patient decide which is right for them. Fortunately for me the only procedure I wanted was an RNY, so it wasn't a problem, however a standard RNY (100cm by their definition) is not ideal for a SMO.
   — zoedogcbr

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