Aetna & Becki

[Guest guest]

 

Hi Becki;

Here's a great URL:

http://www.aetnaushc.com/cpb/data/CPBA0157.html

Unfortunately, the news that it has is not great but I'm still

encouraged. For starters here is what they say about the DS:

Aetna U.S. Healthcare does not cover ANY of the following

procedures because the peer reviewed medical literature shows

them to be either unsafe or inadequately studied:

* Loop gastric bypass

* Gastroplasty using staples to create a small pouch

* Duodenal switch operation

* Biliopancreatic bypass

* Laparoscopic adjustable silicone gastric banding using the

LAP - BAND

However, they also post the medical documents they use to

base their decision on. They are ALL published between 1991 -

1993. Not very current, wouldn't you say? Also, there are only two

documents on the duodenal switch and they're both on the exact

same study. That's also a pretty narrow view.

If you want any help, I'll jump in and start doing some research. I

think the thing to do is to get some more current studies from

some of the exact same sources they're using. What I mean is

that many of their 10 year old work is from sources like the NIH. I

know enough about NIH grants to know that for every negative

thing someone says, someone else will counter with a positive

report.

There's also the ABSA. They also publish and are ALL

pro-surgery since they're all bariatric surgeons. I also think some

strong studies can be found from NYU (Dr. Gagner) and Dr.

Hess in Ohio. They both work out of teaching hospitals and have

continued to publish.

At least now you know exactly what you are fighting against.

That's a start. Do you have an open-enrollment period with other

insurance coverage available to you? Neither Regence Blue

Shield nor Blue Cross ( Premera Blue Shield up here in Seattle)

discriminate between the two surgeries.

Good luck; Hugs;

gobo

DS pre-op

BMI 56

" Sometimes We Never Know How We Influence the Lives of

Others, Yet We Touch Those Lives Just the Same "