In the process of insurance approval for RNY but I want the sleeve!!

My insurance was submitted 3 weeks ago for the RYN and I am still waiting on approval. My insurance DOES cover the sleeve also. Has anyone done this before and how hard is it to change? My insurance coordinator was out on Friday so I couldn't get these questions answered. If it makes any difference I have BCBS Atnea of MO.

Also anyone have any links on VSG and long term success?? I would really appreciate it.


Thanks, Shelly

My company didn't approve the sleeve at the time but would have the bypass but i insisted so appealed the denial and won, but i'm sure you should be able to change your mind, they will need to resubmit the request using the right procedure code. Hopefully you'll get someone who knows more than i do about this. Good luck, the sleeve is the best thing i've ever done. Not sure how many studies you'll find about the vsg as a wls but i know my father had a version of it in 1950, its basicallly a gastrectomy, he had ulcers and they removed part of the tummy. He lived for many years, didn't eat a lot, i always thought he had a fast metabolism but when i got my sleeve i realized that is what he did, and there should be lots of long term studies about that, I hope you get your sleeve soon :o) jeani

My insurance was submitted for the lap band and I was approved. I was almost sure I wanted the sleeve just before the approval was submitted, but I said nothing. When I was called by my doctor's office and told that I had been approved for the lap band, I told them then that I really wanted to do the VSG instead. They resubmitted my info to my insurance company under the code for VSG. I had to wait another 4 weeks for a second approval.
Let your doctor's office know that you have changed your mind as soon as you can so that they can make the necessary adjustments so you won't have to wight as long for the VSG approval

If your insurance covers VSG, then it shouldn't be an issue since the requirements for different procedures are usually the same (I believe that's true with Aetna). Your surgeon's office will need to resubmit your information for the different procedure; you won't have to re-do any of your pre-op dieting or testing that you've already completed. It might take a few weeks for the approval (some are faster than others), and I know a few weeks feels like an etermity when you're so close, but it's worth it to get the procedure you really want.

Long-term VSG stats are sparse, at best, since the procedure has only been performed as a stand-alone WLS procedure for less than 10 years (I want to say only about 5 years, but I feel like that's been the number that was used back I joined OH, so it must be more like 7-8 years or so now). In any case, I would ask your surgeon for the stats of that practice since different practices employ slightly different techniques, sleeve sizes, post-op support programs, etc. You want to know how patients in YOUR program fare.

I did the same thing! I went in for my evaluations and signed the papers for RNY, but I called in 2 weeks later to change it to the Sleeve. It took a couple weeks for the surgeon to finally get to my file to give his approval but thats all I had to do to call.