I have a written copy of the policy statement on bariatric surgery. If you qualify, they will pay for Roux-en-Y Gastric Bypass, Lap Band, and Vertical Gastroplasty (an outdated technique.) They consider sleeve gastrectomy to be "experimental." During the time that I have been satisfying their "6 months of medically supervised weight loss" requirement, I have been researching all of these various surgeries. So now that I have completed that all of the requirements and have qualified for bariatric surgery, I find that they won't cover the proceedure I want.
I have read a ton of articles in the medical journals (primarily Obesity Surgery and Surgical Endoscopy.) It is clear to me that sleeve gastrectomy has weight loss comparable to Roux-en-Y Gastric Bypass without the surgery risks and without the long term gastrointestinal problems such as dumping, diarrhea, malabsorption, etc.
The problem is that there aren't any studies reporting results over 4 years old in the literature. The reason my insurance company won't cover sleeve gastrectomy is that it is "considered experimental." :sneaky2: I was wondering if anyone with BCBS of Texas has been able to get around this problem.
Best wishes