Is Bariatric Revision Surgery Covered By Insurance

So how can you get revision bariatric surgery insurance coverage. Surgical procedures following a previous weight loss surgery that did not result adequate weight loss such as a lap band or realize band to a gastric bypass gastric sleeve or duodenal switch are covered by insurance when the following criteria are met.

I Need A Revision To My Bariatric Surgery Will My Insurance Cover It Obesity Action Coalition

The insurance companies in all the states cover these two procedures under Blue Cross Blue Shield bariatric surgery plans.

Is bariatric revision surgery covered by insurance. The short answer is no. Generally if you are experiencing complications related to your original procedure youll be approved because of a medical need. Insurance companies need one or more of the following boxes checked before they consider covering a revision surgery.

Bariatric Revision Surgery in Mexico Guarantees That You Reach Your Desired Weight Loss Goals Revision surgery is used in order to correct the negative effects complications or poor results caused by an earlier bariatric surgery procedure. Medicare Part A will provide coverage for gastric sleeve revision costs if you will be in the hospital due to this surgery. Suppose my insurance company does not or no longer covers bariatric or weight-loss surgery.

A bariatric procedure is not something most people can afford out of their own pockets. 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. To be eligible for coverage for the initial gastric bypass surgery medical records must show that a patient has been classified as morbidly obese for five years or more.

If the surgery is performed in an outpatient setting Medicare Part B will help cover the costs if you are approved for coverage. 1Medically necessary surgical reversal that is takedown or revision of the bariatric procedure is covered when the beneficiary develops a complication such as stricture or obstruction from the original covered surgery. Large Group Plans Coverage depends on whether your employer has chosen to add it to your policy.

Read on for the long answer If your insurance does not cover weight loss surgery this is called an exclusion This means that the employer who provides the insurance chose to exclude surgical weight loss from coverage in order to purchase a cheaper plan. Bariatric surgery insurance coverage varies by insurance policy. However Aetnas HMO and QPOS plans do not include surgical operations for obesity treatment unless prior approval is given by Aetna.

Insurers increasingly recognize that obesity is a progressive disease and surgery or a revision procedure can provide a viable medical solution. Medicare and Medicaid Bariatric surgery is covered. Coverage for revisional bariatric surgery is determined by your specific insurance provider and plan.

Medicare Advantage plans Medicare Part C also provide coverage for gastric sleeve surgery. Coverage is required by the Affordable Care Act in some states. They even said that if I was eligible for the revision I would still have to follow the 7 month protocol for the WLS.

I know what youre thinking. The patient continues to meet all the medical necessity criteria for bariatric surgery and. Bariatric surgery requires pre-authorization from your insurance company.

NEW ORLEANS WVUE - Governor John Bel Edwards signed a bill ending the 20-year long battle to get bariatric weight loss surgeries covered by insurance for. IndividualFamily Plans. Certain recipients who satisfy Medicares requirements for coverage of bariatric surgeries like the Roux-en-Y gastric bypass may also be covered for a revision with their Medicare benefits.

In some cases adjustable gastric band surgery lap band is also covered. I didnt have their insurance at that time but they said that doesnt matter. Contact your insurance company to learn the details of your particular plan and ask if bariatric surgery is a covered benefit.

Bariatric surgery is often considered a medical necessity therefore many insurance companies do fully or partially cover bariatric surgery. What we know about Bariatric Surgery Insurance companies is that most insurance providers may not cover Bariatric surgery or Aesthetic surgery and even if they do most insurance companies that may cover the surgeries have a deductible that is still higher than the cost we offer for our procedures or they make the patients jump through hoops asking the patients to perform some. My current insurance will not cover the revision because I was self pay 12 years ago.

Check your Blue Cross of Alabama Insurance Policy for bariatric coverage Blue Cross of Arkansas. Gastric sleeve is covered if BMI is. Well in that situation youre going to argue two things.

Insurance requires patient to have a BMI of more than 36 and demonstration of a failed structured weight loss program participation. In the case of primary bariatric surgery as well as revision weight loss procedure which were once considered as purely elective surgeries the insurance companies are gradually willing to change their position. At the same time insurance that covers bariatric surgery may not always be willing to dish out more money when you need a revision.

When youre in need of a weight loss surgery and have Aetna as your health coverage youll be glad to know that it covers the majority of the weight loss surgeries.

Gastric Bypass Revision Surgery 6 Options Bariatric Surgery Source