Today, bariatric surgery is covered by most insurance providers for morbidly obese patients with a body mass index (BMI) greater than or equal to 40, and for those with a BMI of greater than or equal to 35 plus a serious obesity-related condition such as diabetes, heart disease, high blood pressure, arthritis or sleep apnea. Calculate your BMI. Contact your insurance company for policy information on coverage, exclusions, deductibles, co-pay amounts and out-of-network benefits prior to scheduling surgery. Previous weight-loss attempts, physical condition, related illnesses, disabilities and their future impact are taken into consideration to determine medical necessity of the procedure.
At Jeanes, we assist you with the approval or pre-authorization process.
Your primary care physician is an important part of the surgery approval process and he/she may be required to document your non-surgical weight loss attempts. Documentation requirements vary by insurance coverage. The Jeanes staff or your insurance company will provide you with the specific requirements. Generally, documentation consists of the following information tracked on a monthly basis:
- Weight
- Supervised weight loss program
- Counseling sessions
To register for a free informational seminar or to make an appointment for a consultation with a bariatric surgeon at Jeanes, click here or call 215-728-CARE (2273).
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