For “does blue cross pay for bariatric surgery”, insurance covers weight loss treatments under certain circumstances. The blue cross insurance company covers the treatment costs of patients with extreme obesity characteristics. The Blue Cross is based on many criteria when evaluating its insured patients. According to the standards, a doctor’s evaluation report is required for a patient to be operated. In order to have bariatric surgery under insurance, a hospital appointment is required first. Doctors evaluate patients on both physical and psychological criteria for surgery.
The first condition for bariatric surgery is not to have excess weight. The main condition for weight loss surgery is to be extremely obese. Patients who have been trying to lose weight for years but gain more weight are good candidates for bariatric surgery. These conditions are the same for blue cross insurance. Apart from that, just the diagnosis of obesity is not enough for bariatric surgery. The most important condition is that the body mass index measurements are above 40. Blue cross insurance company doctors also have to keep track of these metrics. BMI 40 is not enough to answer “does blue cross pay for bariatric surgery”.
For body mass index measurement, first multiply your height by itself. Then divide your weight by the result. When you do this calculation, you will see a number between 20 and 150. Body mass index is actually a measurement that shows how healthy your internal organs are. A score of 40 and above is required for bariatric surgery. BMI is not the only indicator that you are a suitable candidate for weight loss surgery. The fact that obesity is a life-threatening disease makes it easier for the doctor to make a decision. Diabetes, heart disease, type 2 diabetes sleep apnea are secondary health problems related to weight.
How Does Blue Cross Pay For Bariatric Surgery?
Patients see eligible to ask “does blue cross pay for bariatric surgery” when they have agreed circumstances. The answer is both yes and no as there are some other criteria as well. First of all you have to prove to qualify for bariatric surgery. The blue cross insurance company would like to see at least two obesity-related illnesses occur in a good candidate.
For this, you may have high blood pressure. High blood pressure is actually evidence of the occurrence or presence of heart disease. All numbers above 140/90 prove the presence of high blood pressure, as obesity patients especially eat junk food with excessive salt. High blood pressure patients have symptoms such as headache, weakness, palpitations, excessive sweating, buzzing and ringing in the ears, swelling in the limbs, and nosebleeds. For bariatric surgery you may have hypertension or type2 diabetes as well. People with type 2 diabetes usually score 200 and may have glucose tolerance test as well. You might have Dyslipidemia with or apart from diabetes and hypertension. Dyslipidemia is not mandatory for answering “does blue cross pay for bariatric surgery”. It’s a natural result of malnutrition or eating disorder.
For dyslipidemia, the ratio of good cholesterol and bad cholesterol in the blood is measured. Sleep apnea is also one of the evaluation criteria for a bariatric surgery candidate. It is usually snoring or shortness of breath during sleep. Patients experience sleep apnea due to their excess weight. Having sleep apnea in the evaluation of blue cross bariatric surgery is also effective in the evaluation. Blue Cross also accepts Osteoarthritis as a sign in need of bariatric surgery. It mostly happens by the effect of excessive weight over body. Osteoarthritis is a degeneration of bones or joint cartilage by pressure, usually leads to pain or stiffness.
What does Blue Cross Pay For Bariatric Surgery?
To answer “does blue cross pay for bariatric surgery”, patients should qualify mental criteria too. Blue Cross wants its patients to have competence of consciousness and voluntary approval. For this reason, there is a 18-year-old criterion for you to have legal autonomy and freedom at the time of application. Apart from this, you sign a contract stating that you voluntarily apply for bariatric surgery treatment. You should also get the approval of 3 different doctors.
Blue cross insurance company requires a psychiatrist and psychiatry report in bariatric surgery conditions. With these reports, sufficient intelligence for bariatric surgery, mental capacity and the capacity to continue post-operative treatments are measured. Because weight loss operation is just the beginning of treatment. Many diets, exercises and psychological changes are required after surgery. It is important that the patient has sufficient emotional competence for bariatric surgery.
For what does Blue Cross pay for bariatric surgery the answer only consist 2 operations. Blue Cross only covers gastric bypass and gastric banding among 4 types. Gastric sleeve is not an option. So, if you are planning to have gastric sleeve bariatric surgery, then it’s not an option to cover with BCIC.
Why doesn’t Blue Cross Pay For Bariatric Surgery?
It’s normal you have an unapproved and ask “why does Blue Cross pay for bariatric surgery”. In fact, if the insurance company refuses to pay for bariatric surgery, you can ask them why. But usually Blue Cross rejects your application;
- If there are missing documents or a doctor’s evaluation,
- Unless you have life threatening disease or unhealthy to undergo surgery,
- If you’re committing insurance fraud,
- you are pregnant or in the puerperium,
- If you are asking for an out of scope surgery
- you are not mentally ready for bariatric surgery.
Some patients use private insurance as a tool to avoid high treatment fees. Insurance companies often notice this type of scam attempt. Blue Cross heart does not approve of patients who are at high risk of having a heart attack during surgery, such as high cholesterol. In addition, the cognitive ability criterion that will not fulfill its responsibility in post-operative treatment is important. Continuing to eat wrong after surgery is fatal. Pregnant or postpartum women are not suitable candidates for surgery. The blue cross insurance company is extremely meticulous about the risk of death. In addition, it rejects the applications of patients with missing documents for weight loss surgery