Does Blue Shield Cover Gastric Sleeve Surgery?Yes, Anthem Blue Cross and Blue Shield of California will cover your Gastric Sleeve Surgery as long as your insurance plan's requirements for bariatric surgery are met. Each Anthem Blue Cross and Blue Shield California insurance policy can vary on what weight management or bariatric and gastric surgery expenses are covered or excluded, so it may be easier to have our Gastric Sleeve Insurance Coordinators verify your Blue Cross or Blue Shield Gastric Sleeve Surgery coverage for you. Simply give us a call at 1-855-690-0559 or fill out our FREE Gastric Sleeve Insurance Verification Form. Verifying your Gastric Sleeve coverage is hassle-free with no obligation. Even if you don't meet your insurance policy's requirements, we can send a letter of medical necessity, request an individual need assessment and help you through the appeal process if necessary. Show
Anthem Blue Cross Blue Shield Gastric Sleeve CoverageEvery person is different, and so is each insurance plan; Anthem Blue Cross and Blue Shield of California’s Gastric Sleeve Coverage and pre-approval requirements vary with every insurance policy and potential patient. Per the most recent Anthem Blue Cross Blue Shield Clinical Bulletin SURG.0024, Gastric Sleeve is now covered and available for those individuals who qualify. Part of determining if Blue Cross or Blue Shield cover your gastric sleeve surgery is determining you have a Body Mass Index (BMI) of 35 or greater, along with obtaining a written letter detailing all prior attempts at weight loss programs, including diet and exercise, over the last 5 years. This may be required by Blue Cross or Blue Shield prior to covering any bariatric procedure. A diet and psychiatric evaluation are also required by Anthem Blue Cross Blue Shield in California. If your BMI is below 40, Anthem Blue Cross and Blue Shield will also consider all medical issues and problems related to your weight prior to authorizing coverage of your Gastric Sleeve Surgery. Depending on your Blue Shield or Blue Cross Gastric Sleeve Coverage, you may also be required to undergo 6 to 12 months of medically supervised, non-surgical attempts at weight reduction through nutrition, medication or maintenance therapy, behavior modification, exercise and increased activity. It is also necessary for your physician requesting the coverage to fully explain the gastric sleeve surgery to you so that you completely understand the risks, benefits and how the procedure is performed. This also includes required dietary evaluations and nutritional counseling before and after your surgery to ensure maximum health and recovery. You may automatically pre-qualify for Blue Cross or Blue Shield to cover your Gastric Sleeve Surgery in California if:
Disclaimer: This site is not affiliated with or endorsed by Blue Cross and/or Blue Shield and is for informational purposes only - The following Blue Cross and Blue Shield Gastric Sleeve guidelines have been compiled from various public sources. It is presented online for informational use only, and without warranty as to its accuracy, timeliness, or completeness. This site does not replace any official versions of the information presented, nor does inclusion on this list guarantee coverage. Please check your Blue Cross or Blue Shield policy before proceeding with your surgery.
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Hospitals and DoctorsAnthem Blue Cross Blue Shield’s Requirements For Weight Loss SurgeryFor persons with health coverage from Anthem Blue Cross Shield, you’ll be delighted to know that it will cover weight loss surgery. Obesity Coverage feels very strongly that morbid obesity is a serious illness and that all insurance companies need to cover the life-saving techniques. The majority of the Blue Cross Blue Shield network has some kind of weight loss surgery coverage. Bear in mind that employers have the option of opting-out of any weight loss surgery insurance coverage, which means employee health policies will not offer it. Opting-out will save the company money on premiums. However, even when a policy excludes the weight loss surgery, if BCBS can be shown these kinds of surgeries are medically important for one’s health, the exclusion can be appealed. Important: Blue Cross of California is Anthem BCBS’ trade name, which means the criteria for the surgery will be the same. Pre-Approval Requirements For Anthem BCBSTo be approved for the weight loss surgery, you must meet the minimum requirements:
8 Policies Included In Weight Loss Coverage
What Are The Kinds Of Bariatric Surgeries Anthem BCBS CoversSome large insurance companies have started covering gastric sleeves. However, this procedure is considered experimental and is not covered. The following surgeries are covered:
Will Anthem BCBS Cover Lap Band FillsAnthem BCBS look at the Lap Band Fills as a medical necessity when it must be used to attain proper weight loss levels. For example, you had an modifiable gastric banding procedure that met every criteria for it. If cash paid for the weight loss procedure, the insurance will not cover continuous lap band fills. 3 Procedures Not Covered
Will A Second Surgery Be Covered If Gastric Banding Fails (Revisions)A second surgery can be paid for so long as any surgical weight loss procedure that didn’t cause an adequate amount of weight loss and was covered by insurance. However, the criteria below still need to be met:
A Look At RevisionsRevisions may be covered if documentation of a failure or a surgical complication such as obstruction, fistula or disruption of staple or suture line. Must You Go To A Center of Excellence and In-Network PhysicianThe surgery must take place at a Center of Excellence. However, you do not have to use an in-network surgeon. But, the costs will be higher for you if you use an out of network doctor. They will also need to have privileges to perform the weight loss surgery at the accredited Center of Excellence. You can contact Anthem’s customer service at 1-866-293-2892. You can also look on their website www.anthem.com for the email address and contact number.
Does Blue Cross Blue Shield Florida cover weight loss programs?We offer a wide range of wellness programs at your local Florida Blue Center and online. Programs include nutrition, weight management, exercise, cholesterol, diabetes, pre-diabetes, heart health, stress management and more.
Do you lose more weight with bypass or sleeve?Gastric bypass patients lose between 50 to 80 percent of excess bodyweight within 12 to 18 months, on average. Gastric sleeve patients lose between 60 and 70 percent of their excess body weight within 12 to 18 months, on average.
How quickly can I get bariatric surgery?How long do I have to wait before having bariatric surgery? From the time of the initial consultation, the average wait time is 6-8 weeks. During this time, you will undergo preoperative testing to evaluate whether surgery is a suitable option.
Does Blue Cross Blue Shield Mississippi cover weight loss surgery?Blue Cross Blue Shield of Mississippi does cover weight loss surgery, but your specific policy must include it in order for you get it covered.
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