Champva??
Monica B.
This post might come too late to help you out, but hopefully it will help others.
CHAMPVA now covers the sleeve gastrectomy.
It is not yet in the online policy manual, however you can call the 800 number and find out for yourself! They have no time line set for getting the online policy manual updated.
It's been a long road, but the policy has finally changed! Yay!
I have to say, I'm so friggin excited, but I was the one who got it changed (or at least got the ball rolling on it). I have ChampVA. Last April, I went to see a bariatric surgeon for the sleeve. Half way through my consult visit, the financial lady came in and said, "I'm sorry, but your insurance doesn't cover the sleeve." The surgeon and I went through every inch of the policy to see if there was any way to get it done, and it clearly said that the sleeve was an exclusion. He said that the policy was very antiquated and several of the covered procedures aren't even really done anymore because of the risks associated with them. I am not a candidate for the other procedures because of my autoimmune diseases and vitamin deficiencies. The sleeve is the only one he would safely agree to do.
I left there feeling defeated. I got home and called ChampVA to see if there were any exceptions to the policy but they said, "it will literally take an act of congress to get that changed." CHALLENGE ACCEPTED! Over the course of the next month, I did extensive research on the risks associated with the covered procedures. I also researched other insurance policies to see what their policies were and ChampVa was one of two insurances in the country that did not cover the sleeve. It was insane...there are VA hospitals that do the procedure, but you couldn't get ChampVA to cover it outside of the VA (I'm in jersey and our VA hospitals are terrible...I wouldn't let them cut me). Medicare covers it, Medicaid covers it, tricare covers it and all major medical insurance companies cover it. So, I took all of my information and made an appointment with our Congressman. I provided them with all of the information and Congressman MacArthur said he would address it at the next congressional session. Fast forward to July, I received an updated bariatric policy with the sleeve now covered. My surgery will be the beginning of November.