Requirements For Insurance To Cover Weight Loss Surgery

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. Are between 18 and 75 years old.

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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.

Requirements for insurance to cover weight loss surgery. Minimum 18 years of age or above some plans cover surgery less than 18 years of age also. Must have had obesity for up to 5 years and have documents to prove it. 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.

The Affordable Care Act Obamacare requires insurance coverage for weight loss surgery in almost half of all states. The goal of this documentation is to establish the medical necessity of weight-loss surgery. The benefit plan of the patient should explicitly include weight loss surgery.

Insurance companies generally consider you eligible for weight loss surgery coverage if. 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. Insurance companies follow requirements for weight loss 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. A recommendation letter from your doctor approving the surgery. Keep good records including receipts.

Contact Our Helpful Advisors Here. Your BMI is 35 to 40 AND you have a major health complication such as. 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 have similar criteria when approving a patient for bariatric surgery. Here are the most common requirements. Weight loss surgery helps obese and morbidly obese individuals improve their health.

These requirements include all of the following. BCBS Illinois Pre-Approval Requirements. Some of the common requirements are.

The patient must have tried futilely in at least one weight loss program that is medically approved and supervised. 37 rows Bariatric Surgery. Your Anthem Blue Cross insurance policy covers weight loss surgery unless it states specifically that it excludes it.

How long does it take Medicaid to approve weight-loss surgery. If your surgeon recommends weight-loss surgery he or she will submit medical documentation to obtain pre-authorization from your insurance company. As not all policies include coverage please talk directly to BCBS Illinois to find out if you policy includes coverage.

Cardiovascular disease including high blood pressure high cholesterol or significant heart disease. You need must be between the ages of 18 and 60 years old. Various services and procedures also require referral andor prior authorization.

However to qualify for coverage of weight loss surgery your policy must include coverage. Pregnancy or significant weight fluctuations can create a pocket of. Weight Loss Surgery Eligibility.

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. You can always appeal its decision to deny you coverage. 23 states now have a specific health benefit.

Contact Our Helpful Advisors Here. 5 feet 3 inches. Document other weight-loss attempts made through diet centers and fitness club memberships.

For most patients you will be REQUIRED to take 2 multivitamins 1 Vitamin B12 and 6 Calcium Citrate tablets per day. Some States Require Insurance to Cover Weight Loss Surgery SECTION SUMMARY. You need to be at least 18 years old.

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. Are at least 80 lbs 36 kg overweight. You must pass a psychological evaluation.

Your BMI is 40 or more OR. First get a copy of your policy. Most insurance companies require a Letter of Medical Necessity for bariatric surgery pre-authorization.

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. Requirements for Pre-Approval of Weight Loss Surgery with Blue Cross. Patients who qualify for gastric sleeve surgery usually.

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. In order to be pre-approved for the procedure 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.

You and your doctor need to get pre-approval for weight-loss surgery. And have attained a majority of. What is a Panniculus.

Letter of Medical Necessity. 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. Requirements for Pre-Approval of Weight Loss Surgery with Cigna.

To be eligible for weight-loss surgery you must meet the following requirements. Posted May 2 2013. 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.

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