Saturday, October 15, 2011

Sleeve Gastrectomy - Meeting the "Insurance" company requirements

Unless, you're paying cash, it can be a long time, 3 months to a year or longer or never, to meet the insurance company requirements before they will pay for the Sleeve Gastrectomy surgery.  Apparently, not all insurance companies will pay for this surgery, because some consider it "experimental".

My insurance company did pay for my surgery and here are some of the requirements that had to be met:
1.  BMI (Body Mass Index) of 40 and above or BMI of 35 and above with significant other severe problems like, high blood pressure, diabetes, high cholesterol, sleep apnea, etc.
2.    6 months under a doctors' office weight management program (not programs like Weight Watchers) it has to be at a doctors' office or 3 months at the Bariatric Surgery Office.
3.  Visit a psychiatrist for a psychiatric evaluation.
  4.  Attend a bariatric nutrition class.

Bottom line: If you are considering having bariatric surgery, visit the surgeon's office, as soon as possible and find out what your insurance company requirements are with the surgeon office "insurance" person.  It might be a very long time before you can qualify for the surgery.   It's very frustrating to be emotionally ready to have the surgery, but  having to wait a long time to meet the insurance requirements.

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