Is a sleeve covered under "gastric bypass"?

My insurance company says I'm 100% covered for "gastric bypass surgery or lapband surgery". Is the sleeve covered since it doesn't bypass anything? Or, do I go to my first surgeons consult asking for a DS in two phases and then not get the second? Penny

My initial reaction is that the sleeve won't be covered because, like you said, it is not a bypass surgery. Most surgeons will only do the DS in 2 phases if you are SUPER morbidly obese to the point they feel it is in your best interest to not do the whole thing at once.

Before worrying about it, though, I would call insurance and ask for specifics.

Deb (K9krazzi)  she posts on this board had the sleeve surgury and I believe hers was covered, she can answer the question better than I.  I believe you would have to have a good reason why you would need to have the sleeve as opposed to RNY.  Anyway, I would check with the surgeon's office and the insurance company.   Sorry, I am not familiar with DS in two phases?
Good luck and I hope it is covered for you.

Thanks gals! A DS in two phases would be doing the sleeve first to lose enough weight to then do the bypass.

Penny

I initially went in for a band but when I was on the table, it was discovered that I have advanced cirrhosis of the liver.  The surgeon decided to stop the procedure and after consulting with the hepatologist, it was decided that the sleeve would be the safest procedure for me.  My insurance company approved it in less than 24 hours.  But, I don't know what was sent by the surgeon to substantiate the request.  Good luck to you.  The sleeve is wonderful and I am very happy that I had it done and that my surgeon cared enough about my overall health to not proceed with the band.  PM me if you have any other questions.  Deb

 The sleeve is NOT a bypass nor is it a lap band.  I had my sleeve done 4 mths ago and my insurance covered everything,  However, i have Fed. Blue Cross and they do NOT consider the sleeve "experiemental" as do other insurance companies.  So, i guess it depends on which insurance company you have.

I have also heard (and read on these forums) that it depends on WHERE you live.  Some Blues, in other regions (or states) do not pay for the sleeve.  Chekckit out with your individual ins. comapines. to  make sure.

Susan, I think I may be out of luck then and have to be self pay if I want the sleeve. Will still continue to investigate with my insurance. Thanks, Penny

My experience with my insurance has been that they will cover RNY and Lapband but not the sleeve. Many insurance policy binders include a clause that says they cover WLS that is approved by the NIH as effective in the long term. The NIH has not yet approved the sleeve as effective so many insurance companies will not cover it. My insurance company sent me this in writing and said they would only cover a DS procedure if it were done at once as well. They won't cover it in two phases.

Looks like I may be self pay then, and soon looking into surgery in Mexico. Thanks. I'm still going to schedule a consult; if the doctors office ever returns my calls. Thanks, Penny