Anthem for LapBand???

I have Anthem Blue Preferred Primary Plus (pos). Has anyone been approved for Lap Band that has Anthem? I've heard that they cover RNY but not the Band. The hospital where I'm going for the informational seminar gave me this info. I really want the band.

Patty, Just out of curiosity, why do you want the band over RNY? Dr. C

Dr. C, As of today my weight is 232.2lbs and I'm 5'4". This is very light weight for WLS. I've lost 60lbs on my own since Feb. 03' Down from 292lbs. The band is less invasive and has a shorter recovery time and fewer risks. I like the idea that there isn't malabsorption or dumping with the band and that it can be adjusted to meet individual needs. I follow a high protein/low carb diet now and I work out 3x a week so I feel that the band is my best option. I'm not even considering RNY. Patty

Patty, Sounds like you've researched it fairly extensively. The results in Europe are pretty good but for some reason not as good in the U.S. As long as you're happy with a little less weight loss than a RNY I say go for it. The risk of mortality is certainly less. Dr. C

I have Anthem Blue Preferred Primary Plus (POS) and I was told on the phone by Anthem twice, and My Doctor office was told that WLS was not covered. I know that have approved it in the past. But that is what I was told this past week. I am still depressed and heartbroken.

I just received my benefits book this month and it says under exclusions that the treatment of obesity is not cover, EXCEPT for surgical treatment of morbid obesity. Although I keep hearing that they aren't covering the band because they still concider it experimental surgery. Go to the insurance section of this site, Anthem has approved RNY many, many times and usually pretty quickly. Check it out. Patty.

PATTY, I ALSO THOUGHT THAT I WANTED THE BAND,BUT AFTER READING,HOW THE BAND CAN SLIP,AND DIFFERENT THINGS THAT CAN HAPPEN,I OPTED 4 THE OTHER.WE ALSO HAVE ANTHEM,AND THEY TOLD ME,THAT THEY WOULD NOT PAY.HUGSSSSSSSSSSS SUE KYLE

Sue, You are correct, the band can slip, erode into the stomach, and have all sorts of other problems. Some series show a 40% re-operation rate. Dr. C

Anthem does not cover lap band anywhere in the US. It is a national policy. They are under the impression that it takes 3-5 hours to do this surgery. This is only true if it is done by a surgeon who has not been primarily trained in this technique. The European studies are most impressive; however, the US studies were done by surgeons who perform the more invasive and unfortunately more expensive procedures. It is a true conflict of interest to use them, but those are the breaks. I gave up and am having the lap Ruen-Y done at King's Daughters in Kentucky. You can try and fight them, but they flat out told me "no". They do cover by-pass as long as you can show medical necessity.