Gastric bypass is one of the most popular forms of weight loss surgery. In this procedure, your surgeon makes changes to your stomach and small intestine, affecting the way they absorb and digest food.

Gastric bypass leads to weight loss as it:

  • restricts the amount of food your stomach can hold
  • limits the calories and nutrients your body absorbs
  • changes your gut hormones, which contribute to appetite suppression

Our specialists at Foothills Weight Loss Surgeons in Knoxville, understand that insurance coverage can be a challenging process. And If you’re considering gastric bypass but you are worried about insurance coverage, you’ll be happy to know that this procedure is covered by many insurances. Your coverage may depend on your specific insurance plan and where you live. Most insurance policies also require patients to meet certain medical guidelines before approving bariatric surgery coverage.  

Insurance Coverage for Gastric Bypass

If you are insured by TennCare, you understand that in 2011 TennCare adopted the guidelines that Blue Cross Blue Shield uses for bariatric surgery. You must first talk directly with TennCare to find out if your specific plan has bariatric coverage because not all policies include coverage.

TennCare’s pre-approval requirements include:

  • A body mass index of 40 or greater.

OR a body mass index of 35 and greater with at least 2 comorbidities that may include:

  • Diabetes
  • Hypertension
  • High Cholesterol (hyperlipidemia)
  • Sleep Apnea
  • A documented history of being morbidly obese for at least 5 years. (This is usually obtained from doctors visits such as your annual physical exam).
  • Participation in a medically supervised weight loss program. (This must be documented and it should have occurred within the last two years prior to surgery).
  • A letter recommending weight loss surgery from your primary care physician.
  • Psychological evaluation.

We, at Foothills Weight Loss Surgeons in Knoxville, are committed to providing the best care for our patients. If you are considering bariatric surgery, our experienced staff will work with you and your insurance company to help you find out if your policy covers the procedure.

 

To learn more about bariatric surgery process, attend our free weight loss surgery seminar in person or view it online. https://www.foothillsweightloss.com/seminars/

For more information, please call the Foothills office at (865) 984-3413.

 

References:

https://medlineplus.gov/ency/article/007199.htm

http://surgery.ucla.edu/bariatrics-gastric-bypass

https://www.bariatric-surgery-source.com/bariatric-surgery-insurance.html

https://www.obesitycoverage.com/tenncare-requirements-for-weight-loss-surgery-approval/