Question:
Duodenal Swich for BMI's Greater than 50 ONLY????

I am having problems with my insurance, United Healthcare. I want the DS and was just denied because my BMI is 46, and they reserve the DS procedure for BMI's greater than 50. ANyone else have this problem? Anyone heard of this? I thought you just had to have a BMI or more than 40. They are creating a big fuss over about 15 pounds. I can gain weight, obviously that is not a problem for me, however it goes against the whole reason I am here. Please Help!!! Melissa    — Melissa T. (posted on October 18, 2001)

October 19, 2001
I think the rationale is that they don't want to pay for any wls unless they can be relatively sure (based on available stats) that you will lose enough weight to truly improve your health. Since (statistically) the DS procedure produces lower weight loss that the RNY, they only auth it for heavier people. They're trying to avoid wls failure and revisions. I doubt that you can fight this; and I don't think it's really worth the stress and time involved. Why not just have fun and gain 15 pounds to quality for the DS? My friend had to do that to quality for her rny with our insurer. She had to eat her way up to a 40bmi to quality.
   — [Anonymous]