Insurance and Self Pay Criteria


INSURANCE CRITERIA:

-The individual must be 18 years of age.
-Must be 100 lbs. over ideal body weight.
-Body Mass Index (BMI) must be 35-39.9 with severe comorbid conditions, such as hypertension, type II diabetes, obstructive sleep apnea, coronary artery disease.
-Body Mass Index (BMI) of 40 or greater with no comorbid conditions.
-Evaluation by a psychiatrist or psychologist.
-Evaluation by a nutritionist.

Certain insurances may require that the patient participate in a 6 month physician supervised diet and exercise program.

SELF PAY:

Lap-Band:

-BMI must be 30 or greater with comorbid conditions. (This applies to cash pay patients only. The insurance will not approve the surgery with the BMI lower than 35)
-The individual must be 18 years of age.
-Evaluation by a psychiatrist or psychologist.
-Evaluations by a nutritionist.

Everything else is the same for a self pay patient involving the other surgeries.


 Related Topics

» Health Cost of Obesity
» Financial Cost of Obesity
» Affordability Calculator
 


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