Help!!!

kat72 · August 25, 2005

I just called my insurance carrier (Pacificare HMO) and found out that they cover RNY and vertical banding, but NOT the lap band. I haven't heard much about the vertical band. Does anyone out there have any info. about this procedure? Isn't this the stomach stapling thing? I thought that was done away with. Why would my insurance cover that and not the lap band, which seems safer? I am so upset, all I can see right now is red! Just when I had decided that the RNY was not for me, now I find out that it may be all that I can have done since I am not financially able to pay for lap band surgery on my own. I just feel like crying.

Anwyn · August 26, 2005

Hang in there and keep trying to get it covered! There are some great threads under the insurance section - check them out. You can try a search for your carrier to see if anyone else has had success with getting an exception made. If all else fails, there are ways to finance the band too. Good luck!

kat72 · August 26, 2005

Anwyn thanx so much for the info. and encouragement.

Alexandra · August 26, 2005

Kat, that standard is outdated but there are some carriers who are just very slow about updating their policies. It is probably something you can get over or around, but it will take some time and possibly an appeal or two. Try collecting information from medical sources or other carriers who publish their reasons why VBG is no longer recommended. Good luck!!