Question:
I was denied for BPD because of the severity of the surgery........

I got my demial letter today and immediatly called the insurance company asking for the exact reasons for denial. They said they never have and never will approve the BPD surgery. I asked about the RNY and she said there was a good chance I would be approved for that. Has anyone else had this happen? I really wanted the BPD!    — Colleen S. (posted on May 8, 2002)


May 8, 2002
Hi! The exact thing happened to me. So I finally gave in after two denials. Lap RnY 3-18-02 down 37# and very happy!!
   — RobinLPN.

May 8, 2002
Hi! I've heard that some policies are against providing benefits for BPD because of a high rate of metabolic complications long term. I know some BPD patients and they have not had problems so I can't say the metabolic issues are the problem for certain. I had RNY and am very pleased with it but I know that we're all loyal to our specific procedures. I hope you're able to have the procedure you want. If not, however, at least you have an alternative in RNY. Best wishes to you!
   — ronascott

May 8, 2002
I have heard the same thing, that some insurances don't approve of BPD surgery but will of RNY. I guess that puts you in a situation where you have to make a choice. Do you have RNY or nothing at all. Being 9 weeks RNY, I am doing great. The majority of those out there getting WLS is RNY. I know many who have BPD do so because they want to still be able to eat sweets and not be as restricted in diet and amounts of food. But having been a person who was obsessed and addicted to food, it hasn't been that difficult to adjust to RNY restrictions. In fact I feel like I have been more liberated from food than restricted. So I guess the ball is in your court.Good luck and I wish you the best.
   — Dell H.

May 8, 2002
Thanks to all of you that answered. I have decided to not fight the denial on the BPD and request approval for the RNY. I wanted the BPD because I fear stretching out the RNY pouch. My problems are not with junk food and sweets. When I'm hungry, I want real food......meat, potatoes, salad, and a big glass of iced tea. I will do whatever it takes to become healthy. That's all that matters now. Thanks again!
   — Colleen S.

May 8, 2002
Colleen, just another tidbit. My biggest fear would be that I wouldn't be able to eat enough with RNY. I used to stuff myself, and still never feel satisfied. It is almost a miracle how that has changed since surgery. My whole desires, want and tastes have dramically changed and I literally am not obsessed with food anymore. Good luck and best wishes.
   — Dell H.

May 8, 2002
I was kind of in the same boat...I wanted the lap-band proceedure but my ins. co would only cover the RNY so I went with that. Not to get into a flame war about it, but the complications from the DS really scare me...it seems the most radical of the WLS. I would go with the RNY - I bet you'll find your tastes change enough to comply with the post-op "diet." Warm wishes...
   — rebeccamayhew




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