This is so frustrating! I've been jumping through hoops since last SEPTEMBER to get all my appointments scheduled, and I'm almost at the last step: the EGD, after which my doctor will schedule my RnY. I just learned that neither of my insurance companies consider the EGD to be medically necessary. I'm double-covered with my husband's insurance because it's free at his work as long as it's secondary coverage, and my own insurance specifically excludes bariatrics. The actual RnY has been pre-approved through my secondary coverage.

Both companies are different branches of Blue Cross, so maybe that's the issue? I'm really annoyed because it's a HDHP, so my out of pocket was already going to be substantial, and paying cash for the EGD means I could have done self-pay elsewhere months ago!

Anyone else have trouble getting the EGD approved? My doctor said that this is becoming a common way for insurance companies to avoid some of the costs associated with bariatric surgery.

Edited June 24, 20215 yr by cellbell

That's so frustrating! Insurance in this country is such a nightmare, but I've heard that in other countries, WLS isn't often covered by national insurance at all. I don't have to have EGD, so I don't know if my insurance would cover it. So far, I've just had a lot of $50 copays for all the specialist visits (I have a lower deductible but it will only apply to the surgery itself. My plan is weird for the deductible.). I also have BCBS, but it's a PPO. Good luck with your surgery!