BCBSMA VSG

It would be really nice if you could search the message boards. but, since you cant i will ask

has anyone been approved for vsg through bcbsma? i have ppo and am expecting to be denied and go through the appeals process. if anyone else has anything they feel helped them in the process, i would really be happy to hear it.

thanks!

Hi Kelly,

I don't know....but I doubt it. Last I checked there aren't any surgeons in Mass that preform the VSG, and my BCBSMA ppo doesn't cover out of state procedures. I hope that they do cover you!

Martha

bcbs ma doesn't cover it.  See policy #379 (you can google it) for details.  I don't know if it can be appealed successfully.

There are folks on the DS board who are very knowledgeable about fighting for coverage and solving other problems that might arise.  VSG is basically the first stage of DS, so it would be a similar process.  i've had some lay it out for me exactly how to proceed and what to expect.  results are not guaranteed of course.

i didn't 'want to fight - i wasn't convinced VSG was the best option for me anyway - but if you are willing to jump through the hoops (and i would recommend it if you are convinced it is the best option for you) you can definitely get a lot of support and direction.

there are a few surgeons here and there with some VSG experience, i found a couple of candidates, although i didn't actually contact them to confirm.  my impression was they didn't have a ton of experience (not like RNY where there are surgeons availible who have done literally hundred and hundreds if not more than a thousand procedures).  so you might have to go out of state.  it's possible you can still fight for coverage since the procedure may not be reasonable available to you in-state.

I don't know anything about BCBSMA...sorry.  But, there are a couple of us trying for the VSG in MA.  I am looking at the BIDMC program and another poster is going through the program at Bringham & Women's....I believe.  I can tell you that I (and I think the other poster too!) are both prepared for a long road...possibly filled with appeals but that we're dedicated in trying for the VSG.  There is no other option for me....so, like Victor Navorsky in The Terminal...I wait. :)  Thus far, I have had my initial consultation, met with the nurse, attended my two info sessions and met with the psych and nutrition depts.  GL to you!