Has anyone ever switched insurance companies for the VSG?

MAchick
on 11/4/13 12:29 am
VSG on 01/27/14
After doing all the pre-op appointments, I found that my insurance won't cover VSG, only Lapband or RNY. Since I have to reapply for insurance anyways, I think I'm going to try to switch to a company more likely to approve the VSG. I'm still looking into it, but I think my best chances are with BCBS.

Oh this process is long and complicated for sure! I've met so many more obstacles than I thought I would, but I am determined to make it work. I'm hoping by February I can be approved and have surgery. ..
mickeymantle
on 11/4/13 12:38 am - Eugene/Springfield, OR
VSG on 07/22/13

you should check there requirements, you may need to wait a minimum time before this is covered 

idi you talk to the old company , to a supervisor , my company when I called everyone gave me different answers , yes it was covered , no its not, this is required, no that is, ask for the supervisor , ask for any answers in writing

talk to your surgeons insurance person they know what companies cover what   , and what there requirements are

ps my company covered band , sleeve and rny , just not the ds

    

   175 lb  lost,412 hw 336sw,241 cw surgery July 22 2013,surgeon Dr Colin MacColl,

 

  

                                                                                                             

 

 

 

Jackie T.
on 11/4/13 12:39 am - KS
VSG on 12/19/12

Just make sure it will be covered if you switch.  Not all BCBS cover weight loss surgery.  In Kansas they don't.  I have BCBS Highmark and they do but it is also part of a rider that my husband's company carries.  Also who told you that it was not covered?  The insurance company?  My doctor's office told me it would not be covered but they were wrong and I knew that.  Make sure all of your insurance questions are being answered by the insurance company themselves along with the doctors office.  Some office personnel just assume and/or are not aware that a change was made.  In October 2012, my company made reg changes that allowed the VSG but prior to that it was very difficult to get.

Highest Weight: 285 SW: 264.6 CW:163.1   Surgeon's GW: 189  PCP's GW: 165-170  

My GW:  154   MFP:  jteaford                  

        

hollykim
on 11/4/13 12:52 am - Nashville, TN
Revision on 03/18/15
Actually,every insurance co covers most. Weight loss surgeries. The real question you need to be. Seeking the answer to,is if your employer is going to buy the rider that covers the vsg.
If you company doesn't buy the rider for the vsg or for any Wls for that matter,then it will never be covered. This is where " exclusions" to weight loss surgery occur. It isnotthe insurance company,it is the employer who ultimately decides what will or will not be offered by what they purchase from. The insurance company.
GL

 


          

 

G5x5
on 11/4/13 2:02 am - VA

I switched.

I was on my wife's plan originally, which was slightly cheaper, but they required a 12 month supervised program before approval.  Their option was also pretty strict as to what you had to do during the 12 months.  Basically, they suck and were throwing out every obstacle they could to avoid paying for any WLS options.

To solve the problem, I enrolled myself back into our company's plan during open enrollment and moved forward with that.  Of course, while I was waiting for it to kick in, they started requiring six months of PCP visits thing which slowed me down anyway.  However, they were still less strict about it than the other plan so all worked out well.

 

HW: 255 (6/5/13), SW: 240 (6/19/13), CW: 169 (9/16/14)

M1: -26,  M2: -17,  M3: -5,  M4: -13  M5: -12  M6: -11  M7: -8

M8-10: Skinny Maintenance (10k Training)   M11-13: On Break

M14+: **CROSSTRAINING FOR ALL AROUND FITNESS**

Google NSNG and learn the right way to eat each day

MAchick
on 11/4/13 2:32 am
VSG on 01/27/14

My insurance  is sponsored by the state, so they only cover basics. I was first told that they would cover if medically necessary. After speaking with a liason from the surgeon's office, I was told that my specific insurance only covers lapband with them, sometimes gastric bypass. She went through months of sleeves in their system and they all seem to have been done with BCBS, one or two Harvard Pilgrim or CIGNA. I am going to have them try anyways for the heck of it, but doesn't sound like it will be approved. Also, that insurance company will no longer exist as of 1/1/14.

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