Insurance Consultation
I met with the insurance coordinator today at the bariatric surgeon's office. She told me the requirements that each individual must complete before surgery are different according to which insurance that you have. My primary insurance is through Cigna-Healthspring and my secondary insurance is Texas Medicaid. After verifying my insurance she told me that bariatric surgery is covered by my primary insurance if it is medically necessary for the treatment of morbid obesity (which mine is). She gave me a list of requirements for my insurance.
My insurance requirements:
1. BMI of 35 or greater AND one or more of the following comorbidities:
a. Type 2 diabetes
b. Uncontrolled hypertension(high blood pressure)
c. Uncontrolled hyperlipedemia(high cholesterol)
d. Obesity induced cardiomyopathy
e. Obstructive sleep apnea
f. Obesity related hypoventilation
g. Psuedotumor Cerebri
h. Severe degenerative arthrtis of the spine and/or weight-bearing joints where obesity prohibits appropriate treatement,
i. Hepatic steatosis without evidence of active inflammation.
(health problems caused by another condition. In this case that would mean health problems caused by obesity).
2. 3 months of meetings with the dietitian for nutritional counseling and 3 weigh-ins to be completed at the meetings with the dietician.
3. Documented evidence in your medical record of a repeated failure to lose weight through diet, exercise, programs such as Jenny Craig or Weight Watchers, and/or diet medications.
4. Psychological evaluation
