BCBS of MA and the BPD with DS... anyone gotten approval for this??

Okay.  I live in OH, but have BCBS of MA insurance.  My doctor wants me to have the biliopancreatic diversion with a duodenal switch.

However, according to my policy... the BPD/DS  is considered investigational because it has 'not been scientifically proven to improve net health outcomes'..... blah blah blah...

I was wondering if anyone has successfully won an appeal with BCBSMA for this surgery.  I would love to hear from you if you have... or if anyone has any advice!!

Thank you greatly!

 Hi Sharon,

BCCSMA does not approve the BPD/DS because the RNY is successful for most people.  It doesn't mean its a better surgery, just that folks can be successful with it.  To my (albeit limited) knowledge it is difficult to get them to approve the surgery unless there is some very compelling evidence that the DS is the only surgery that will work for you.

Honey if I thought I could get it approved, I'd be getting one!!

Good luck with the fight, and let us know if you hear anything...

Kim