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Any luck with insurance coverage



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Hi, I am wondering if anyone has had any luck getting the ESG procedure covered by insurance? Even better if you have experience with CareFirst BlueChoice. I have called them to ask about coverage and no one has an answer since it is not considered surgery. I also have not been able to find out what codes may be used for billing, as they said they could look into it that way.

Thanks!

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From what I remember they cover all obesity-related surgeries, but I do not remember ESG being on the list specifically. I also think that members in Virginia had fewer hoops to jump through than members in DC and Marylin. This is from the CareFirst site.

Blue Distinction® Specialty Care

Blue Distinction logo

The hospital you select can have a direct impact on the care you receive and your procedure results, but finding the right facility can sometimes be a challenge. The Blue Distinction Specialty Care recognition program identifies health care facilities with proven expertise in delivering specialty care. There are two designations:

  • Blue Distinction Centers - Health care facilities recognized for expertise in delivering specialty care.
  • Blue Distinction Centers+ - Health care facilities recognized for expertise and cost efficiency in delivering specialty care.

Blue Distinction focuses on high-volume, high-risk and high-cost areas of specialty care, including:

  • Bariatric Surgery centers provide a full range of bariatric surgical care services, including inpatient care, post-operative care, follow-up and patient education.

Edited by New To This23
Adding info

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