HELP

Hi Anyone, I have a replacement for Medicare BCBS of Georgia...I need the sleeve not the bypass which is what BCBS says they will pay for..I have a low BMI ,but a lot of comorbities..My heart has slightly enlarged and I have high blood pressure...I really would benefit from the sleeve since I need some gastric juice and no malabsorbortion.sp?..How do I go about fighting this? BCBS goes by Medicare guidelines... I'm 53 and want to live to see my grandkids...Kathryn

Hey KAthryn I responded to you one the VSG board, but now have a question. Is it just that they told you that was there policy, or were you actually denied. You said you need some gastric juices and no nal-absorb-- is that b/c of your medical conditions? Usually, if a doc can make the argument that the bypass part would be more dangerous (like if you had IBS or gut problems like Colitis. Crohn's, ulcers) they will usually approve just the Sleeve. Sometimes they may want to offer you the Lap Band, but I think the doc can make an argument for not having a foreign body in you with an enlarged heart. Have you seen the doc? What do they think? They usually know the best ways to present the case to the insurance. Good luck Kahlua

Hi Kah, I just got the deniel letter in the mail Sat. from BCBS..And it tells me what I have to do to appeal..So there is hope..Thank you., Grateful, Kathryn