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Is DS considered Bariatric Surgery?



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Hey, I'm new to bariatric surgery. I decided on Duodenal Switch, but my insurance (Blue Cross PPO) is being unhelpful about giving me anything close to a straight answer on whether they cover duodenal switch. I cant find it on their website under bariatric surgery. I cant even get someone at their dedicated bariatric & transplant number to return a call.

Now I'm wondering if it is even considered bariatric surgery, as this website has DS buried under "other".

Can anyone give me any advice? I talk to my bariatric surgeons office (i went ahead and started the process anyway) about it and Blue Cross gives them a hard time too.

So is DS considered bariatric surgery or is it regular surgery?

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Bcbs where? All bcbs are different. Some are owned by WellPoint. But most are independent

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Bcbs where? All bcbs are different. Some are owned by WellPoint. But most are independent

Blue Cross of California. The company is split up here in California.

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There are hundreds of BCBS plans out there, even within the same state. Your member services number on the back of your card will get you to the customer service professionals that you need to speak to. They can tell you if bariatric surgery is covered, be prepared that it might not be it's not universal by any means. It's the first thing I looked into when choosing my insurance.

There are apparently a number of financing companies that specialize in self pay patients, you may have to consider that option.

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I'm sorry I should have been more clear, that's what I get for trying to post on my breaks. Hehehe. I have already talked to the insurance company as much as possible. The customer service reps dont know what i'm talking about, and always end up e-mailing me my group policy, which is nice, but never addresses my issue. There is a dedicated number for Bariatric questions, but they never answer nor do they return messages even though they specifically say to leave a message. *shrug*

I was just wanting to know if, in general, y'all's insurances considered it bariatric or regular surgery.

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Lovely WellPoint anthem - jackpot.

Ok take a look at this site. The duodenal switch is bariatric for them. That said each employer who purchass the plan can decide what is or is not going to be covered.

You need to check your personal group policy to confirm no bariatric exclusion

http://obesitycoverage.com/anthem-bcbs-requirements-for-weight-loss-surgery/

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If the member services of your plan do not know what Bariatric Surgery is ask to talk to a supervisor, it should be plain in your plan whether or not those services are covered, and it is highly unlikely to be considered regular surgery since it is an elective procedure.

BTW I work for BCBS for Pharmacy Benefits, and I've seen it states clearly on most plans, sometimes referred to as Weight Loss surgery/treatment

Edited by msdesigna

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YES the DS is bariatric surgery.

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Oh wow! Thanks y'all, I could hug you if that wouldnt be weird and stuff!

According to my group policy & the links, the DS is covered, and my company apparently encourages it, per my HR rep. Wont worry on why that is, happier not knowing when it comes to work logic.

Thank you so much again. Weight off my shoulders!

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Weight off my shoulders!

@@beachykeen

looks like things are lookin up

btw - you'll have a lot more weight off besides your shoulders :D

good luck

kathy

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Yes it is bariatric surgery. If you talk to 3 different customer service reps at BCBS you will get 3 different answers to the same question. You should call and get your evidence of coverage from BCBS. They have to send it to you, whether a pdf version you can download from the internet or the hard copy.

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Of course, DS is a bariatric surgery. A unique weight loss surgery performed by a limited amount of surgeons worldwide, the Duodenal Switch is also known as a vertical gastrectomy. Like other surgeries, it is designed to restrict the amount of food that can be eaten by a patient, prompting weight loss most effectively and powerfully in comparison with other weight loss surgeries.

DS and vertical gastrectomy are not the same thing. Yes, most of the stomach is removed during the DS, but your intestines are also rerouted like with bypass, so there is a malabsorption component. The vertical sleeve gastrectomy only involves removing a large portion of your stomach. You can convert to DS after VSG if you do not achieve adequate weight loss or experience weight regain.

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