Requirements For Insurance To Cover Weight Loss Surgery

Various services and procedures also require referral andor prior authorization. Requirements for Pre-Approval of Weight Loss Surgery with Cigna.

Pin On Bariatric Surgery Weight Loss Surgery

Requirements for Pre-Approval of Weight Loss Surgery with Blue Cross.

Requirements for insurance to cover weight loss surgery. Are at least 80 lbs 36 kg overweight. Medicare will pay for abdominoplasty or a tummy tuck after weight loss surgery if it is deemed medically necessary due to excess skin that causes rashes or infections. Patients who qualify for gastric sleeve surgery usually.

You need must be between the ages of 18 and 60 years old. You and your doctor need to get pre-approval for weight-loss surgery. Keep good records including receipts.

Contact Our Helpful Advisors Here. You can always appeal its decision to deny you coverage. You must pass a psychological evaluation.

Insurance companies follow requirements for weight loss surgery. Contact Our Helpful Advisors Here. BCBS Illinois Pre-Approval Requirements.

How long does it take Medicaid to approve weight-loss surgery. Some of the common requirements are. Your Anthem Blue Cross insurance policy covers weight loss surgery unless it states specifically that it excludes it.

Have a body mass index BMI of 40 or higher or have a BMI between 35 and 40 and an obesity-related condition such as heart disease diabetes high blood pressure or severe sleep apnea. Most insurance companies require a Letter of Medical Necessity for bariatric surgery pre-authorization. The goal of this documentation is to establish the medical necessity of weight-loss surgery.

However protocols are a bit more stringent if you want insurance to pay such as requiring a 35 BMI and a completed medically supervised weight loss program. In order to be pre-approved for the procedure you must meet the following requirements. What is a Panniculus.

First get a copy of your policy. Insurance companies generally consider you eligible for weight loss surgery coverage if. Your BMI is 35 to 40 AND you have a major health complication such as.

And have attained a majority of. Some States Require Insurance to Cover Weight Loss Surgery SECTION SUMMARY. Document other weight-loss attempts made through diet centers and fitness club memberships.

Unless you have a policy that specifically excludes weight loss surgery surgery is going to be covered provided that you meet specific criteria set forth by Cigna. The benefit plan of the patient should explicitly include weight loss surgery. To be eligible for weight-loss surgery you must meet the following requirements.

These are not an option and for the majority of patients will be purchased as over-the-counter supplements at your local. Similar to other insurers Medicare will likely require a BMI of at least 35 your weight must also be causing serious health issues and youve attempted for years to lose weight through diet and exercise. Pregnancy or significant weight fluctuations can create a pocket of.

Most insurance companies provide coverage for medically necessary weight loss surgery but coverage depends on several criteria and varies by state and by insurance provider. 23 states now have a specific health benefit. Weight Loss Surgery Eligibility.

Weight loss surgery helps obese and morbidly obese individuals improve their health. Minimum 18 years of age or above some plans cover surgery less than 18 years of age also. 5 feet 3 inches.

You need to be at least 18 years old. Must have had obesity for up to 5 years and have documents to prove it. A recommendation letter from your doctor approving the surgery.

The patient must have tried futilely in at least one weight loss program that is medically approved and supervised. Have a BMI body mass index of at least 40 or a BMI of 35 and above with one or more obesity related comorbid condition calculate your BMI. The Affordable Care Act Obamacare requires insurance coverage for weight loss surgery in almost half of all states.

Your BMI is 40 or more OR. Most insurance companies have similar criteria when approving a patient for bariatric surgery. I just went to the doctors yesterday and i got a surgery date for 627 penning insurance fidelis fingers crossed it wont take long.

Letter of Medical Necessity. As not all policies include coverage please talk directly to BCBS Illinois to find out if you policy includes coverage. However to qualify for coverage of weight loss surgery your policy must include coverage.

Cardiovascular disease including high blood pressure high cholesterol or significant heart disease. For most patients you will be REQUIRED to take 2 multivitamins 1 Vitamin B12 and 6 Calcium Citrate tablets per day. If your weight loss surgery insurance company refuses to cover your weight-loss surgery even after youve met all its requirements try not to panic.

If your surgeon recommends weight-loss surgery he or she will submit medical documentation to obtain pre-authorization from your insurance company. Are between 18 and 75 years old. Severe obesity a BMI of 40 and severe co-morbidities or super obesity BMI of 50 and less severe co-morbidities that may be remedied with weight loss.

37 rows Bariatric Surgery. Here are the most common requirements. Posted May 2 2013.

Consideration for bariatric surgery is generally warranted only when adolescents have experienced failure of 6 months of organized weight loss attempts and have met certain criteria. Eligible patients must also have attempted and failed at previous weight loss efforts and need to pass a psychiatric evaluation to be recommended for weight loss surgery. These requirements include all of the following.

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