Got another turn down today. Now they say they will cover gastric banding but not Lapband it is not FDA approved.YES IT IS and it is the same thing AM I WRONG.

ladysplenda

You're both right and wrong.

There is another procedure called Vertical Banded Gastroplasty (VBG), which uses a non-adjustable band to restrict the stomach and create a pouch. It is NOT the same thing as lap-band, which is distinguished by being adjustable.

But, of course, the laparoscopic adjustable gastric band (AGB, LAGB, lap-band) is indeed approved by the FDA. It was approved in June of 2001. Proof of that should be easy to find, so if that's the only reason they're turning you down, you're in a good spot.

Possibly they will cover VGB. The way I ask was if this procedure is not covered. You say you cover gastric banding please tell me if there are any doctors in the area that do the procedure that you cover.They could not orwould not tell me.

Thanks

ladysplenda

Just ask them if they can refer you to any bariatric surgeons in their network. Then ask the DOCTOR if he or she performs the procedure that you want. Most surgeons do more than one type of procedure, and it's not the carrier's job to keep track of that.

I don't know what the problem is, I have BCBS and they approved and covered my surgery. I was just forced to pay the out of network cost and my max out of pocket was $1500.00