Anyone in Raleigh area doing VSG?

Hi everyone, I am coming out of "lurking" for a bit because I can't seem to find this on the forum.  I apologize if it is there somewhere but I have been reading for days and can't find an answer to my question I am researching WLS (and kudos to all of you who have already taken the plunge!) and feel like the sleeve would be best for me, for a variety of reasons.  I am wondering if anyone is currently doing the VSG in the Raleigh area, and also, if anyone has had their insurance cover it?  I have the BC/BS State Employees 90/10 Blue Options and any tips about how to work with them would be greatly appreciated. Thank you for your time with this, and for all the good information I am getting by reading the forums...keep up the good work!  I am sure there are hundreds of other lurkers like myself you are helping without even realizing! Well, back to my lurker's cave

I think that on the website at BCBSNC that the VSG is not covered because they say it is not as effective or something like that. I have the PDF that describes what they will and will not cover at https://www.bcbsnc.com/services/medical-policy/pdf/surgery_for_morbid_obesity.pdf so be sure to review the procedures they allow and disallow carefully. I understand they are pretty good about approving the surgery but only if it is medically necessary. They are no longer seeing the VSG as a standard of care and therefore it is not Medically necessary. I hope this helps.

Thank you for your response.  I have that BCBS pdf. too, but I had read it differently.  I thought it said the VBG (banded) was no longer covered, but I didn't see anything about the Sleeve.  Of course, reading that policy makes my eyes cross, so I could easlily have misunderstood what I was reading. Has anyone ever had BCBS pay for a VSG? All that aside, even if I had to pay out of pocket, I don't even know if anyone around here does the VSG, or if I am better off planning a trip south of the border.  Thanks again for your response and good luck to you! I just poured over it again, and i see now, under not covered 2f, they have added the sleeve  well, maybe it is negotiable????  I would love to hear if anyone has gotten them to OK it........

while I don't live in the Raleigh area PERMANENTLY, I AM visiting here for a few weeks ... I had the VBG with sleeve as the first part of my DS -- and my insurance covered it ALL.  I'd love to hook up with some local folks while I am here the next couple weeks.  Yea, I know ... I just missed your meeting!  Drats. Ample hugs ...

I'm closer to Greensboro than Raleigh, but my first choice for WLS is the VSG also.  Unfortunately, I also have BC/BS of NC and not only is it not covered, they have it classified as "investigational" (as opposed to the VBG which they classify  "not medically necessary").  From what I have been able to piece together, this classification is extremely hard to appeal.  But who knows, if you have specific reasons why you need to have a VSG instead of the RNY, you may be the lucky one!!  I have seen where their bariatric surgery policy is up for review this coming August, so I'm hoping and praying for a miracle that they might change their policy on the VSG.  Other than that, I'm probably looking at a RNY for myself.  I'm already surgeon-shopping for that anyway. The only VSG doctors in NC I have been able to find are not very close to either of us.  There is one in Concord, one in Mooresville, and a couple in Charlotte, I believe.  I would imagine all the others would begin to offer the VSG if the NC insurance companies would just cover it!!  It is a much simpler operation than the RNY with a much lower complication rate.  What surgeon wouldn't prefer that!?! You might want to look up and contact Becky G who posts here and on the VSG forum.  She has the BC/BS State plan also, I think, and she went through the appeals process with them for a VSG.  She finally gave up and decided to self-pay and go to Mexico, but she has loads of information I'm sure she would be willing to share with you. Good luck with your quest, and keep us posted!! Cathy W.