UI grad student with Wellmark BCBS, want DS

Hey folks,

I'm a UI Grad student and I've been researching WLS forever. Sometimes I think I research WLS more than my actual studies.  I've settled on the DS after all of my research. I have Wellmark BCBS and it says "weight loss surgery" is covered, but it doesn't specify the type. I am bracing for a denial, though. I plan to fight it, if so.

I haven't found anyone in Iowa that does the DS, though I heard someone in Des Moines now does a VSG. I have been looking at surgeons outside of Iowa that do a lap DS, and so far I have contacted a few.

I am really excited to get going on this new chapter in my life. I've been overweight since I was a kid, so just the thought of being "normal" sized is frightening and totally amazing. I have been on Weigh****chers for years, and despite my efforts, I never go below a 40 BMI even at my healthiest. Right now I'm at a 50.6 BMI so it's really wearing me down.

Anyway, just wanted to say hi and introduce myself. I'm new to the OH boards, but I hope to post here often. 

I also have the same insurance. I went through Mercy Center for Weight Reduction in Des Moines. My doctor was Steve Cahalan. He and Mercy were GREAT! I got my lap band last May. I lose about 1 pound a week. Its a slow process but healthy. I feel great! I like the band because I know its for life! I have seen so many people get the gastric bybass and 5 years later they start to gain it back. And some it works great for them. I still watch what I eat and I have changed my entire eating habits and how I work out. But surgery is not a cure all as it is a tool.
A lot of luck to you! What ever you decide to do; you will not regret it. Its the best gift you could  give your self and your family. The gift of a healthy  prolonged life.

God Bless
Amanda

 Cool, congrats on your success. =)

I know that the band won't work for me, my BMI is over 50 and the DS has the best success rate for that.  The lifestyle and side-effects of the DS are the most agreeable to me, too. Hopefully Wellmark will see it that way.

I am so glad to read that you have done the necessary research to make an informed choice as to which surgery seems to work best for you.  But the next step is to hear from a surgeon his/her informed opinion as well.  There may be information they can provide you. 

I don't know where you are in your studies, but I would suggest you try to find a surgeon where you can fully participate in the supporting program.  If you select a surgeon outside your area, will you be able to fully benefit from their program?  The surgery is just one piece of the puzzle.  The best programs also have nutritional, behavioral, and physical support elements.  Participation in support groups is also very helpful for long term maintenance and success.

I didn't do much research on DS but have read many posts about its high success.  I had the RNY and lost 240 lbs. 

Good luck with your research and finding the right surgeon/program.

Wellmark covers the DS if your BMI is 50+, so you should be covered.

Here is a LINK to the WLS policy.

Does anyone know if Wellmark requires a 6 month Dr. supervised diet?

The policy doens't specifically say that, but one of the surgeons I consulted said they do.

I am looking at getting the VSG, but they still consider it investigational.  I am going to appeal if they deny.

On February 25, 2010 at 4:02 PM Pacific Time, WeekendWarrior wrote: Wellmark covers the DS if your BMI is 50+, so you should be covered.

Here is a LINK to the WLS policy.

Does anyone know if Wellmark requires a 6 month Dr. supervised diet?

The policy doens't specifically say that, but one of the surgeons I consulted said they do.

I am looking at getting the VSG, but they still consider it investigational.  I am going to appeal if they deny.
I had VSG Jan. 4th this year. I also have BCBS, but it's federal if that makes a difference. My insurance is with Illinois rather than Iowa as well. I did not need a 6 month Dr. supervised diet. I was approved first try, which was a pleasant surprise! My VSG doctor was Dr. Christopherson in Davenport, IA.

Dr. Christopherson in Davenport also does the VSG. I had mine done lap. I'm also a student and go to college 2 hours from home, but I managed to make it back and forth to Davenport for my appointments. It's at Genesis Bariatric Clinic in Davenport and they have an excellent care program. My BCBS (federal) covered almost everything.