NOTE: WE ACCEPT MANY MORE INSURANCE PLANS THAN ARE LISTED BELOW, THESE ARE COMPANIES THAT HAVE SPECIFIC REQUIREMENTS THAT WILL NEED TO BE MET FOR APPROVAL OF WEIGHT LOSS SURGERY. PLEASE CALL US IF YOU HAVE QUESTIONS ABOUT YOUR INSURANCE PLAN, AS REQUIREMENTS MAY VARY PER POLICY.

Universal Treatment Requirements
NIH criteria for surgical treatment of obesity:
(BMI = Body Mass Index: wt (kg)/ht(m)sq.)
BMI > 40 (80-100lbs overweight)
BMI > 35 with presence of severe co-morbid conditions such as diabetes, GERD, hypertension
If you are below a 35 BMI, you are not a candidate for weight loss surgery.

United Healthcare (all plans)
Subject only to plan limitations and universal treatment requirements.

Aetna US Healthcare (all plans)

• Five year documented (in patient record) history of morbid obesity
• Psychiatric evaluation
• Three month supervised pre-surgery diet and exercise regimen

CIGNA (all plans)

• Legible documentation from physician supervising at least two non-surgical weight loss attempts within the past five years; one of which has to have been in the past 12 months and at least 6 months in duration. Documentation should include name of therapy, duration of therapy, and notes about the progress including at least monthly weigh-ins. Recent trial must also include evaluation by a licensed dietitian. NOTE: A physician's summary letter is not sufficient documentation - the records must be in the patient's chart notes.
• Psychiatric Evaluation
• Care plan for long-term follow-up. (Provided by surgeon)

Great West (all plans)

• Five year documented (in patient record) history of morbid obesity
• Psychiatric evaluation
• Dietitian consultation and evaluation
• Documentation of previous weight loss attempts
• Documentation of a 12 week, physician-supervised weight loss attempt, having taken place within the previous 12 months

NOTE: GREAT WEST WILL NOT COVER ADJUSTABLE GASTRIC BANDS IF BMI > 50

Unicare (all plans) NOTE: WE CAN ONLY ACCEPT UNICARE CLASSIC PLANS

• Listing of all previous non-surgical therapies for weight loss.
• Demonstration of psychological readiness for procedure. (psychiatric
  evaluation)
• Medical clearance from primary care physician or internal medicine specialist.
• Evaluation for diabetes/ endocrine disorders by endocrinologist
• Care plan for long-term follow-up. (Provided by physician)

WILL NOT COVER LONG-LIMB (>100cm) BYPASS, WILL NOT COVER ADJUSTABLE GASTRIC BANDS

One Health (all plans)

• Listing of all previous non-surgical therapies for weight loss.
• Demonstration of psychological readiness for procedure. (psychiatric evaluation)
• Medical clearance from primary care physician or internal medicine specialist.
• Evaluation for diabetes/ endocrine disorders by endocrinologist
• Care plan for long-term follow-up. (Provided by surgeon)

Blue Cross/ Blue Shield

• Requirements vary per plan, per state of plan administration.
• We are currently only able to see PPO and POS plan holders. We are out of network for all others.

Pacificare (all plans)
WE ARE NO LONGER ACCEPTING NEW PACIFICARE PATIENTS

Humana (all plans)
WE ARE NOT ABLE TO ACCEPT HUMANA PLANS