Does Insurance Cover Revision Weight Loss Surgery

You have a qualifying body mass index BMI of 35 with obesity-related health problems or a BMI of 40 with no accompanying health problems necessary. The bottom line is yes AmeriGroup does cover weight loss surgery if you have chosen the right insurance plan.

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Many insurance companies require another diet history.

Does insurance cover revision weight loss surgery. AmeriGroup weight loss surgery. Ad Contact Our Responsive Insurance Advisors. Medicare will cover the cost of gastric sleeve revision.

When bariatric weight loss surgery revision is covered. While some surgeries have been successful there have been instances when a revision is necessary. In general the coverage by insurance providers for revisional bariatric surgery mirrors that of the primary procedure eg if youre 100 pounds over your ideal weight or you have significant obesity-related health problems.

Some types of surgery also change the connection between your stomach and intestines. It is important you and your surgeon understand the plan for your potential revision. If your surgeon or primary care physician submits the above claims using a weight loss surgery CPT code your insurance is unlikely to cover it.

This type of surgery is only used for people who are very overweight and have not been able to lose weight with diet and exercise. Will my insurance provider cover the procedure. Revision bariatric weight loss surgery such as replacement andor removal of an adjustable gastric band surgical repair or reversal or conversion to another covered bariatric surgical.

As is often the case with Medicare certain conditions have to be met for Medicare to pay for your gastric sleeve revision. Does AmeriGroup cover weight loss surgery. The short answer is yes.

Medicaid covers weight loss surgery but not all surgeons accept Medicaid If your insurance policy covers weight loss surgery insurance will only pay for it if. Weight-related arthropathies that impair physical activity. But not 100 of the time.

However if your doctor submits the above claims using a NON-weight loss surgery CPT code the claims will likely be considered covered benefits. Medicare will cover the cost of weight loss revision surgery. The number of people undergoing weight loss surgery has been on the rise.

First that weight-loss surgery should be a covered expense because it is used to treat co-morbidities in addition to obesity such as diabetes or hypertension. GEHA considers revision bariatric surgery eligible for coverage when one of the following medical necessity criteria have been demonstrated. Successful gastric bypass revision should help patients resume the weight control plan they had after their initial gastric bypass surgery.

My current insurance will not cover the revision because I was self pay 12 years ago. As is often the case with Medicare certain conditions have to be met in order for Medicare to pay for your weight loss revision surgery. Your weight loss surgery insurance for gastric bypass may cover costs related to the diagnosis surgical procedure and post-op recovery.

Once you understand this fact its easier to understand why you cant file an appeal and get them to cover. You and your doctor need to get pre-approval for weight-loss surgery. This means that the employer who provides the insurance chose to exclude surgical weight loss from coverage in order to purchase a cheaper plan.

Revision surgery to address perioperative or late complications of the original bariatric. They even said that if I was eligible for the revision I would still have to follow the 7 month protocol for the WLS. You need to meet requirements and deemed severely obese.

As for everyone else if your insurance does cover revision weight loss surgery you want to be aware of all the required documentation required before submitting the claim. The long term costs of obesity related health conditions far outweigh the short term cost of addressing those concerns through surgery. Does Medicare Cover Weight Loss Revision Surgery.

Ad Get Weight Loss. Ad Get Weight Loss. Ad Contact Our Responsive Insurance Advisors.

Does Insurance Cover Revision Surgery. Having weight-loss surgery is a big step. Endoscopic revision is not covered at this point.

This surgery makes the stomach smaller. Get Instant Quality Info. I didnt have their insurance at that time but they said that doesnt matter.

And second that this is a request to correct a failed procedure that may cause significant problems in the near future and as such it is not for obesity or weight-loss. But not 100 of the time. The short answer is yes.

Get Instant Quality Info. Insurers all have different requirements but they generally cover revisions to the band sleeve or bypass to address weight regain if you meet these criteria. If your BMI is greater than 40 or if you have a BMI of 35 along with a medical problem related to obesity.

Other than normal restrictions to diet or exercise related to recovering post-operatively no additional changes should need to be made to the types and amounts of foods they can eat after the first gastric bypass. Some insurance policies offered by AmeriGroup cover bariatric procedures but we suggest talking to your AmeriGroup insurance agent directly to get a clear answer. Covered services may include surgical services performed in the operating room hospital stay pre- and post-op medical exams and lab tests prescription medications and check-ups with your bariatric surgeon and other doctors.

Many insurance providers are now also of the opinion that covering weight loss and revision surgery now will in fact prove to be a money saver in the long run. Medicare covers some weight-loss surgeries including laparoscopic banding surgery and gastic bypass surgery. In this case revision is defined as a change or modification of previous surgery.

If your insurance does not cover weight loss surgery this is called an exclusion. Bariatric surgery is surgery to help you lose weight.

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