While there are general guidelines regarding qualification for bariatric surgery, our program offers a variety of services, surgical and non-surgical, regardless of BMI, lifestyle and related illnesses.
The BMI calculator on this site follows the established National Institute of Health guidelines; and will provide a general idea of what weight loss options you might consider. Take a moment and complete the calculator then reach out to us on the accompanying form so we can discuss your options.
Weight loss options based on BMI*:
- 25-29.9 – nutritional counseling, medical weight management available
- 30-35 – nutritional counseling, non-surgical and surgical options available*
- 35+ – nutritional counseling, non-surgical and surgical options available
*Surgery may be a consideration if your BMI range is between 30 and 35 and you currently are experiencing obesity health related issues.
In general, most insurance companies base qualifying criteria on the NIH guidelines.
Many insurance plans cover bariatrics however the specifics of your plan are outlined on your plans website or through employer Human Resources departments. If you have questions please consult your insurance company or reach out to us for general questions. We have an experienced Patient Coordinator who will help navigate those particular details. The following are examples of how plans may vary:
- Body Mass Index: Insurance companies use this standard measurement to determine eligibility.
- Medical Necessity: Has health is deteriorating to a dangerous point? Documentation of diseases associated with obesity will be required. If the insurance company determines the procedure to be primarily aesthetic or cosmetic, they are likely to deny coverage.
- Diet and Exercise History: Has there been a concerted effort to lose weight through traditional means? A detailed log of eating habits and exercise regimens may be required. Your insurance plan may require a medical weight loss program, such as those we offer, for 6 months or more before you can qualify for surgical procedures.
- Appropriate Surgical Risk: Do the benefits of the surgery outweigh the risks? Serious medical problems including cardiac, pulmonary and abdominal issues may preclude you from qualifying for weight loss surgery. You will have to undergo various tests before surgery to make sure you are an appropriate candidate.
- Type of Procedure: Many insurance plans cover bariatrics however the specifics of your plan are outlined on your plans website or through employer Human Resources departments. If you have questions please consult your insurance company or reach out to us for general questions.
- Medicare: Most plans provide coverage for surgery provided the procedures are performed at a Center of Excellence facility such as ours. Visit www.cms.gov and www.asmbs.org for more information.
If other weight-loss methods have not worked, bariatric surgery may be the right choice for you or your loved one. Our programs help address the physical, mental and emotional challenges of surgery by developing a personalized care plan. Find a location close to you to schedule a consultation.