Interest in revision, does insurance cover it

Topazblk
on 2/11/10 4:22 am - GA

Does anyone know if Insurance covers the Stomaphyx revision surgery?

If so is there a particular code that can be given to the insurance provider to verify?
Does anyone know of a surgeopn that does the procedure in the metro atlanta area?


Thanks
Michele

smileyjamie72
on 2/12/10 5:40 am - Palmer, AK

Michele-

I do not think that this is covered by any insurance company.  I am not sure why... but I remeber reading back on here, that most everyone had paid out of pocket for it, and most of the time, there was initial weight loss caused by the liquid which was regained.  So, from what I have read....... (my own opinion) just a watse of $$$$


-Jamie

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003  
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

 

 

 


 

 

 

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

(deactivated member)
on 2/12/10 9:22 am - Bayonne, NJ
 I checked BCBS, Aetna, Cigna, Oxford - not a single one is covering it.  They consider it experimental, and the experiment is failing. I have seen so many posts on here from people who say that they took off 20 lbs, only to regain it as soon as the liquid diet stopped.

The cost of the StomaphyX procedure is roughly $9,500 to $10,500.

Cost for my full RNY to DS revision?  $5.00. Thank you, Horizon BCBS NJ.
Blue_Rattie
on 2/18/10 3:08 pm
BCBS covers DS?
Karen ~ Had surgery 4-13-10!! Lost 30lbs in 3months pre-op
Highest 350 ~ surgery weight 297.5 ~ current 195 ~ goal 175 (August 2012)


(deactivated member)
on 2/18/10 7:07 pm - Bayonne, NJ
Yes, they cover the DS. I had mine with Horizon BCBS Direct Access PPO in NJ.  People on the DS board have mentioned other BCBS providers including Federal.
Blue_Rattie
on 2/18/10 7:47 pm
Ahh okay. I have UHC and they will only cover RNY and lap-band. But my hubby is considering changing jobs and wants to move up to the Portland (OR) area. Something for me to keep in mind. Thanks!
Karen ~ Had surgery 4-13-10!! Lost 30lbs in 3months pre-op
Highest 350 ~ surgery weight 297.5 ~ current 195 ~ goal 175 (August 2012)


Nunyo B.
on 2/20/10 7:10 am
Hi Karen,

Others on the DS board had UHC and won appeals to have the DS approved.  You may want to mozey on over to the DS board and ask them for their input.  Don't limit your choices just because your insurance says you only have 2.  You have more!  You may have to work for it, but the DS is definitely worth it!!

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