Do any surgeons take insurance for MGB?

Hello, I am new here to the message board and was wondering if anyone knows if there is a surgeon who takes insurance for the Mini Gastric Bypass?..I am now in the phase of thinking about the Lap Band system..the Dr takes my insurance and I know it will be ok...I do not know why I am afraid of the full Gastric Bypass...any or all feedback, suggestions, anything would be super wonderful here...Thank You in Advance for any help!....Ginny.

Ginny,  I don't know of any that do cover it, however Dr. Rutledge is now doing a "mini RNY" that he is accepting insurance for. 

Hi, thank you Dena.I will call Dr Ruthledge today and see if he accepts my insurance..have a nice day!..Ginny.

Ginny, things may be different today but back when I had my Lap MGB, my insurance completely (90% with BCBS) covered it. My BMI was barely the minimum too. My doctor back when I had my Lap MGB (2001) was Dr. Peter O'Brien in Sioux Falls South Dakota. I'm in Iowa so I had to travel but it was well worth it. Dr. O is an older guy but he knows his stuff.  I think the "issues" with insurance approval or lack of approval, as far as the Lap MGB goes (in my case) also depended on which State you live and the insurance policies and practises  within your state. I DO KNOW that if you're from NC where Dr. R is from (I think)......and if you have insurance there and want to submit........."FORGET IT". MGB is considered experimental (or some crap like that) in NC. My state.....not an issue! $18,000  is pretty stiff but when you consider that in 2001, my insurance was billed about $20-$25K.  Another option is to go abroad. Manyt people wouldn't even consider it but a LOT of people do it these days. You can get a Lap RNY or a Lap DS for $10,000. Something to at least think about. Best wishes to you and I hope you have great sucesses with you insurance company. Peggy/IA [email protected] 

As far as I know most doctors accept insurance. However traveling abroad like is not a bad idea too. India for instance has some great and advanced weight loss clinics. Foreign patients are given preference and special care. Also, its much cheaper here.

Hi Ginny, My name is Ingrid. I'm also new to the message board and trying to get MGB approved for myself. Not that it's my health issue, because I am a very good candidate, it's my insurance, or lack of enough. Have you been to any of the Seminars they offer? OHSU offers a free seminar re: the diffrerent Bypass surgeries they offer etc. You can ask questions and it's very helpful. Also I have found that searching and reading online as well as watching the Discovery Health Channel. Today (saturday) I watched a MGB special with the gentleman who played Buck Rogers on TV many years ago. He had gained quite a bit of weight and his health was a huge issue. He researched and spoke with other people who had had the MGB surgery and spoke with a surgeon and his patients that had, had it done. I would urge you to go to thier website and look up todays programing adn review what they had to say about it. It was very successful for him, as a matter of fact his diabetis went away, heart disease adn high blood presure as well as other medical problems associated with obesity. For myself, theres no question in my mind that I want this procedure so that I can LIVE! and have a good quality of life.  I wish you all the best, e-mail me if you like. Ingrid*

After researching WLS for the past 4 years I finally have insurance that covers it and I am ready to go.  Right before I got my insurance I seriously researched and considered the MGB surgery after seeing that same special on the Discovery Channel.  My husband and I both cried when we watched it. We were also excited because the price was less than RNY (except that I live in St. Louis and I would have to travel to one of his locations) .  I wrote to Dr. Rutledge and really researched the surgery.  The only data on MGB surgery seems to be from CLOS (the doctors' group that until recently was all related to Rutledge).  That didn't sit well with me.  Then I got my insurance and found out that it wasn't covered.  I am a lawyer so I went to work to find out how to get the surgery covered.  In doing more research I decided against it.  The numbers just aren't in for my comfort level and other surgeons don't seem to be following suit.  WLS surgery is big business and if that surgery was the next big thing I would think other surgeons would be scrambling to start doing it.  Instead ... no one is following.   The surgeon I found near my home told me that there is some kind of loop that the MGB makes with your intestine and he didn't think that was a good idea.  I am not good at medical jargon (although I am getting better), after many more questions I do not feel comfortable with the MGB. Those are just my thoughts, but research any surgery thoroughly.  We are just plain folks on this site!

HI Jennifer Thank you for the information. I have been researching this for the last two years, but the MGB surgery was something new I saw. Unfortunately for me I'm still unable to find a surgeon that will take my insurance. My Doctor(PA) is currently helping me put a case together to appeal this. I hope it is approved. I don't understand really how this disease can be taken so lightly by so many. It's life threatening, you would think that that would be enough..... I wish you hte very best. Ingrid

I don't think the insurance companies take it lightly, I think they clearly don't want to pay for it for fear of the millions of morbidly obese people that would make claims.  So they make it difficult (the number 1 most denied insurance claim in America!), they put up hurdles like diet history (and they often don't pay for the conventional program that many of them require before you can get precert for surgery).  They send out a lot of initial denials because many of us will go away.  Many of us are so beaten down, so depressed and feeling "unworthy" so we do in fact go away.  The key to it all is exactly what your ID says "Never give Up!"  The squeaky wheel does seem to get the oil.  I am working on squeaking my heart out right now and will not stop until I get what I need and I am entitled to ... healthcare coverage from my health insurance company!

As for the MGB go for it, but get prepared to make a case that the MGB isn't "experimental" surgery.  You may want to contact CLOS and tell them that you want to get approval for it and ask them to send you all the documentation and studies they can to support the fact that it is not "experimental."  that may be tough since they are the only ones doing the procedure, but you never know.

You go for it girl!

Keep us all posted.  I know there are many people who would like to have that procedure.

Jennifer