Does BCBS of SC cover weight loss surgery?

Blue Cross Blue Shield, the only Obamacare insurer in South Carolina, does not cover bariatric surgery for the more than 200,000 enrollees in that state. The state also doesn’t cover the procedure for state employees and their spouses and children, another half a million people.

Does SC Peba cover weight loss surgery?

The South Carolina Public Employee Benefit Authority (PEBA) runs the State Health Plan. … “Bariatric surgery is not a covered benefit of the State Health Plan.

What BCBS plan covers bariatric surgery?

Blue Cross Blue Shield of Texas (BCBSTX) covers weight loss surgery. However, some policies do specifically exclude weight loss surgery. Use the contact information at the bottom of this page to find out if your policy has a specific exclusion for weight loss surgery.

Does Blue Cross pay weight loss surgery?

Weight loss surgery is considered an effective treatment of morbid obesity. While most of the Blue Cross insurance policies do cover weight loss surgery, not all of them do. … It is important that you meet these criteria in order to benefit from the insurance company’s coverage for the entire process.

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How do I get my insurance to cover weight loss surgery?

You and your doctor need to get pre-approval for weight-loss surgery. Similar to other insurers, Medicare will likely require a BMI of at least 35, your weight must also be causing serious health issues and you’ve attempted for years to lose weight through diet and exercise.

Will Medicaid pay for weight loss programs?

For children enrolled in Medicaid, the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit covers all medically necessary services which can include obesity-related services.

How do you pay for bariatric surgery?

Thankfully, there are six financing options available to help make the cost more manageable.

  1. Secured medical loan. According to Bariatric Surgery Source, one common source of financing is a secured medical loan. …
  2. Hospital payment plan. …
  3. 401(k) loan. …
  4. CareCredit. …
  5. Health savings account. …
  6. Personal loan.

11 июн. 2018 г.

What if my insurance doesn’t cover bariatric surgery?

If your employer-provided insurance plan doesn’t cover bariatric surgery, you may need to do some lobbying on your behalf, either with your company’s human resources department or your union reps, Wheeler says. “If you want these benefits added, go to HR, go to your employer and advocate for yourself,” Wheeler says.

What insurance companies pay for bariatric surgery?

Many PPO insurance providers are now providing coverage for Gastric Sleeve, Gastric Bypass, Distal Bypass and Lap-Band Removal. Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare and United Health Care typically cover weight loss procedures.

How long does it take to get approved for gastric sleeve surgery?

Insurance Authorization Process

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This process takes approximately 30 days.

Which weight loss surgery is best?

The study found that gastric bypass appeared to be most effective for weight loss: Gastric bypass surgery resulted in an average 31 percent loss of total body weight in the first year and 25 percent of total body weight after five years.

How long do you have to be off work after weight loss surgery?

Most patients return to work in less than two weeks. Gastric bypass recovery time: A one- to three-day hospital stay, followed by four to six weeks for full recovery. Most patients will need one to three weeks off work.

How much is gastric sleeve with insurance?

Your out-of-pocket costs will be dramatically lower if your insurance covers gastric sleeve surgery. For example, the average cost of gastric sleeve in the United States is $19,190. Insurance typically pays over 80% of the costs, bringing the average bill down to $3,500 or less.

Is a gastric sleeve covered by insurance?

However, many procedures are not covered by insurance. Historically, gastric sleeves, duodenal switches, mini-gastric bypasses and other ‘experimental’ procedures are not covered. Today gastric sleeves, laparoscopic gastric bypass and lap gastric bands are typically covered by most major insurance companies.

How much do you have to weigh to get bariatric surgery?

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

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What’s the cheapest weight loss surgery?

To help you make your surgical decision and plan your cash payments, we’ve included this procedure cost list:

  • Surgical Costs for Self-Pay Patients – Basic Packages.
  • LAP-BAND® Removal – As low as $2,200* …
  • LAP-BAND® – As low as $11,560* …
  • Gastric Sleeve – As low as $10,000* …
  • Gastric Bypass (RYGB) – As low as $15,500*
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