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Re: Digest Number 4315

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In a message dated 7/7/01 6:50:18 PM Eastern Daylight Time,

duodenalswitch writes:

<<

> Hey, ya'll!

> I really need some help about my insurance! Does ANYbody know of

> anyone who works for BellSouth who has been approved for this

> surgery? (the DS)

> OR anybody who has been approved by any of these insurance companies:

> Blue Cross/ Blue Shield of Alabama

> Kaiser Permanente HMO

> United HealthCare EPO >>

I have made a few posts that never showed up, so don't know if this one will

or not. Just spent at least an hour on this one site which listed

information on insurance companies and who approved/denied wls and what the

people had to go through. Most were for RNY, however, if you look hard

enough you can find a few for DS.

I think we need something similar at the DS site, listed in the same way. I

specifically was looking for Ohio.

http://www.obesityhelp.com/morbidobesity/insurers2.phtml?State=OH " >

Click here: www.ObesityHelp.com - Insurers, Agencies, Commissions

On this site, I found people who had the RNY thru Kaiser, but they had to

work with a dietician for six months First, and then they got RNY approval.

sounds stupid to me - if we haven't tried ENOUGH diets in our lives to get to

this point, I don't know who has!

I also found what is Aetna's policy on this where they specifically say they

do not approve the DS

quote: " 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 "

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

I hope this post shows up and I hope some of my posts about insurance are

helpful to other members.

This is the 2nd time I am posting this. NONE of my posts are showing up

anymore!

:-(

Carole

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Carole,

Your best bet appears to be United Healthcare or Aetna (Aetna approves on a case

by case basis)..but the best way to tell is to get your benefits book from your

HR person for both United Healthcare and Aetna and check their list of

exclusions. Kaiser is so far only doing the RNY in all states, except possibly

California and Blue Cross/Blue Shield is trying to call the BPD/DS

'investigational' now and are leaning towards not approving, so I wouldn't get

involved with them either!

Good luck!

Anita

Pre-op in Denver

> In a message dated 7/7/01 6:50:18 PM Eastern Daylight Time,

> duodenalswitch@y... writes:

>

> <<

> > Hey, ya'll!

> > I really need some help about my insurance! Does ANYbody know of

> > anyone who works for BellSouth who has been approved for this

> > surgery? (the DS)

> > OR anybody who has been approved by any of these insurance companies:

> > Blue Cross/ Blue Shield of Alabama

> > Kaiser Permanente HMO

> > United HealthCare EPO >>

> I have made a few posts that never showed up, so don't know if this one will

> or not. Just spent at least an hour on this one site which listed

> information on insurance companies and who approved/denied wls and what the

> people had to go through. Most were for RNY, however, if you look hard

> enough you can find a few for DS.

> I think we need something similar at the DS site, listed in the same way. I

> specifically was looking for Ohio.

> http://www.obesityhelp.com/morbidobesity/insurers2.phtml?State=OH " >

> Click here: www.ObesityHelp.com - Insurers, Agencies, Commissions

>

> On this site, I found people who had the RNY thru Kaiser, but they had to

> work with a dietician for six months First, and then they got RNY approval.

> sounds stupid to me - if we haven't tried ENOUGH diets in our lives to get to

> this point, I don't know who has!

>

> I also found what is Aetna's policy on this where they specifically say they

> do not approve the DS

> quote: " 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 "

>

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

>

> I hope this post shows up and I hope some of my posts about insurance are

> helpful to other members.

> This is the 2nd time I am posting this. NONE of my posts are showing up

> anymore!

> :-(

> Carole

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