Why won't insurance cover Fobi procedure?

I've asked this question several times and in several different ways, but the responses I've received (although welcomed) haven't given me a clue as to why this particular procedure is not covered. It essentially is the Open RNY procedure with a few extras. The stomach is transected vertically and a silastic band is placed at the stoma, you have a gastrostomy with a gastrostomy site marker put in the unused portion of the transected stomach (this is in case damage occurs to the pouch or if there is too much weight loss, this marker (tube) can be located and you can receive meds or feedings directly into the unused portion of the stomach). I have no idea what the exact cost of a Open RNY will be, but my surgeon has indicated that my insurance will probably approve the Open RNY, but if I want the Fobi part of the procedure it will cost me out of pocket $1800.-$3200.00. Can anyone out there tell me why this is? This procedure is not experimental, it has been around for many years. This procedure is being covered, at least here in Georgia, by Medicare and Medicaid. Why can't I request and receive the procedure my doctor feels will be better for me and my long term weight loss management when I am being insured through preminums paid at my husband's place of employment? IF ANYONE CAN ANSWER THESE QUESTIONS PLEASE LET ME KNOW AT [email protected]. Thanks, Jo-Dee

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