NC approval for MGB by Blue Cross Blue Shield of NC

Anyone out there had approval for the MGB by BCBS of NC? If so, please post immediately. I've been denied and I don't understand why when they are willing to pay for a more invasive Roux-en-Y procedure that has more long term risks that are statistically significant.

I have been reading the policy. It is considered investigational which is not covered because more study is needed to demonstrate how safe the procedure is. I hope this helps

Lots of hx with the MGB and Blue Cross etc----Also MGB is less invasive--and while succesful to many---others end up having to have a revision to RNY--also complications of reflux etc seem to be greater with MGB--its a give and take--a person decicison for sure to be made--I was on the MGB track a few years back---and wound back up on the RNY list--years later-I made my choice--knew what was right for me---and only hope all will work out for you in whichever you chose! I have no regrets at all--and sure that none of us do---in the fact that we are all losers now! Best Wishes! Lisa 338.5/150/? LBL scheduled for 12/21/06

Read my profile. But for now I will sum it up. 13 month fight. 2 grand outta pocket(paying surgeons fees, attorney fees, and pre testing fees. MANY sleepless nights...but SURGERY TOMORROW! Its a long tiresome fight. But I won. Steve

Do you have the name of the lawyer you used. 2 grand is small compared to $17k.

Gary Viscio. all you need to do is log on to the insurance help forum. He is the forum leader. Steve

oops, just realized you won't be seeing this today. Hope all went well.

Hi When the MGB was first done, NC Blue Cross covered it. Then there were some coding issues with the surgery and they stopped covering it. It is as safe as any of the other wls out there, but it is hard to work with the insurance companies once they feel they have been wronged. Paula