Question:
Anyone start out wanting the BPD/DS and then have to select the RNY
because Insurance wouldnt approve and you simply couldnt afford to do the BPD/DS with Cash Pay? I just found out that my ins. wont cover the DS which I was positive was right for me. I like the idea of the better quality of life after the DS but dont want to forego surgery because I cant afford the DS. Anyone else out there want the DS but settle for the RNY? I mean I need the surgery regardless, so either will be beneficial to me right? — lillbitofsin (posted on June 5, 2003)
June 5, 2003
I was in the same boat. My initial contacts were with patients who had the
DS and were VERY happy with their outcomes. I've decided to find a closer
surgeon, so will have the RNY instead. After looking a little closer at
the differences, trying to find the silver lining, I have seen several
sites where the surgeons indicate that the BPD/DS is a much-more aggressive
procedure, some will only do it for failed RNY, with less long-term postops
to note outcomes, and the RNY has proven the test of time. So, I'm
actually pretty happy about my decision to take what I can get!
— bethybb
June 5, 2003
Robin, if you really want the DS, then perhaps you may want to appeal. I
have read several accounts on AMOS and other sites where patients have
appealed the insurance decision to deny the DS because they deem it as
"experimental", which is pure hogwash. The DS has been done for
many years in Europe, but has been steadily picking up steam here in the
U.S. I think the real reason the insurance companies deny it is because of
money. It costs a little more than the RNY. <p>You have to decide
whether or not you will be happy with your decision 2 or 3 years from now.
It's a tough spot to be in. There are other options if your insurance
company refuses to pay. You could go to Brazil for $8000 or go to Spain for
$11000. I've heard very good things about the DS surgeons in these
countries and have read many happy accounts from their patients. <p>I
have a friend who decided the $26,000 she would have to pay here in the
states was about what she would have to pay for a new car, and it was an
investment in her life rather than an expense. So she self-paid 2 years ago
and is so happy with her life now.<p>I wish you the very best in
whatever you decide. If you go with the RNY because of the insurance
hassle, you will lose weight, too. It just won't be as easy keeping it off
afterward. But there are thousands of very successful RNY patients on this
site and around the world. God bless.
— artistmama
June 5, 2003
I initially wanted the DS but my insurance only approved the RNY - and 10
months later I don't regret my decision one bit! If you want further
details you can read my profile or drop me an email. Best of luck to you -
10.5 months and down 153 pounds
— [Deactivated Member]
June 5, 2003
You may want to point out to the insurance company the increased risks of
the RNY such as staple line disruption, stoma closures, leakages, and the
disruption of normal digestion because of the bypassing of the pyloric
valve. Ask them to reconsider. Be prepared with research. Your DS
surgeon should be able to provide it. Also let them know that BCBS covers
the DS without question. Good Luck!
— merri B.
June 9, 2003
Hi Robin. I think there are risks with all of the WLSs. BPD/DS is still
somewhat relatively new (from what I've been told). I don't believe there
is anything wrong with your decision for wanting to have the BPD/DS. It
would greatly depend on your insurance. I do, however, somewhat disagree
with what has been mentioned about "BCBS covering the DS without
question"~I only say this because that depends on the type of plan you
have, and the state in which you live. As far as the better quality of
life, ALL of us hnow have a better quality of life since we have all of the
excess poundage off of us. No more pain, discrimination, increased
self-esteem. In the RNY, whether open or LAP, there is the possibility of
staple line disruption, leakage, and the like. Unless you have thoroughly
made up your mind that you are ready for this lifestyle change, you will
gain weight on ANY Wls you decide. I chose the RNY, because "I"
needed the discipline that this surgery provides as far as sweets,
pastries, etc. I did not want to have any other surgery that allowed me to
eat the very stuff that put the weight on me in the first place. Research.
Like Merri said. You'll make the right choice.
— yourdivaness
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