LAP BAND AND AHCCS??

EVETTE K.
on 3/30/04 5:23 pm - TUCSON, AZ
I WAS WONDERING FOR A FRIEND OF MINE IF AHCCS HAS BEEN KNOWN TO COVER WLS SURGERY, SHE HAS DIABETES, HIGHBLOOD PRESSURE AND CHOLESTEROL AND IS MAINLY INTERESTED IN THE LAP BAND PROCEDURE. THERE IS ALSO A POSSIBILITY OF HER GETTING ON BCBS , SO WHAT WOULD YOU SUGGEST SHE DO TO TRY TO GET COVERED FOR THIS SURGERY.
baddgurrl
on 3/30/04 11:21 pm - Chino Valley, AZ
As far as I know AHCCCS will only pay for the open gastric bypass, and not the lap or the the band I could be wrong, but they are pretty specific. Depends on which arm of AHCCCS she is on as to whether the fight is as hard as some others, Mercy Care seems to be pretty amenable with Dr.'s backing and the requirements are a little tougher than your average insurance company. As long as your documentation shows attempts to lose weight, and Dr. supervised conversations for a period of time (I think one year) they are pretty quick to respond with co-morbid conditions. You pretty much do not get to pick the procedure though, although they do have the premier surgeons in the field on their provider list, Dr. Newhoff is one, and he has been doing this since 1977. Good luck to her and she needs to stay on the paper trail and keep copies of everything that she sends because things get lost so easily.
Wendy T.
on 3/31/04 10:31 pm - Apache Junction, AZ
Hi Evette, I know that Mercy Care pays for Laproscopic RNY through Bariatric Treatment Center at St. Luke's Hospital in Phoenix. I don't know if they cover the adjustable Lap. Band. Take Care, Wendy T.
baddgurrl
on 3/31/04 11:09 pm - Chino Valley, AZ
That is interesting because they will not pay for it through my surgeons office as far as I know, I should say though I chose my doctor for his experience, and he only performs open, and after much research I decided I would much rather have the open anyhow. I already have a scar on my stomach from gallbladder surgery and want him to have full view of everything there is to see, plus my experience with lap wasn't so great with all that painful gas they shoot through you. Just my experience I guess.
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