Kaiser insurance- high BMI

I believe it is at the surgeons discretion, but Kaiser does give the doctors guidelines that they have to follow.

It doesn't sound like the insurance company is holding this up. It sounds like no surgeon is willing to do the surgery at his current weight, correct?

It seems that way. I don't believe they have experience operating on someone his size. He does realize that he will have to lose some weight before they will approve him. I just wish they could have been honest from the beginning so we could have moved on and not wasted everyone's time.

Generally when surgeons refuse high-BMI surgery it means they have no experience with those of us who were super high weights. If you are in CA, have you contacted Dr. Ara Keshishian? He is known for the DS and has a good reputation.

I had lost 300 pounds before my surgery, but was still at a BMI of 78, and my surgeon operated without blinking an eye because he had done many surgeries on the obese. He was trained at a university health center, though, in residency, which means he had access to this which not everyone does. My VSG surgery had zero complications as a result.

So, yeah. There *are* surgeons who will do it, and more over, do it very well with great skill. Here they do at University of Chicago, where they perform surgery on very high BMI individuals of that weight, including the duodenal switch. Dr. Prachand was one of the first people to do a lap DS on very high BMI folks in the Midwest I think (?) if not the first. Elmhurst Hospital in Illinois also has operated on individuals of that size (the bariatric program I went to...my surgeon was trained by Prachand, actually). I think he's operated on people at least 600 pounds, though they don't do the DS at Elmhurst yet (they do it at U of C)

If your husband absolutely cannot get the care he needs in-state, Kaiser can be petitioned to cover it out of state. Individual providers can also work with an insurance company to be in-network for one person, but it is rare they do that/rare insurance allows us to. If it is Medicaid, most states have Medicaid that is required to cover procedures despite distance. For instance, here in Illinois, there are people who go from Carbondale to Chicago or out of state if they can't get care, because the care they required was unavailable.

I would call the University of Chicago and ask if they could take Kaiser...people from all over the country go there for bariatric surgery.

Surgeons at major university health centers will be more likely to have operated on very high BMI patients. I would call local universities in Cali... and then branch out.

Thank you so much for your response . This is very helpful. You have given us a lot of great info.

Dr Keshnian will take him and I'm pretty sure he takes Kaiser too. The duodenal switch would be best with his BMI, but it will take a fight through Kaiser, for they always decline the first request.

I tried searching for Dr Keshnian and couldn't find a location or website to contact him. Do you know his first name and location?

Sorry, I misspelled his name.

Dr Ara Keshishian

Pasadena, CA

Central Valley Bariatrics.

Great! We will give him a call. Thanks so much for the info!

Dr. K's website is at: https://www.dssurgery.com