These procedures include but are not limited to, gastric plication, mini-gastric bypass, and others. If a procedure is medically necessary, coverage will be provided. Drug therapies (covering authorized medicines – as needed).Īll procedures not included in the list are excluded from coverage even if each case is investigated.Up to four visits to a dietitian for nutritional counseling.Visit a counseling physician every three months after surgery.Patients who undergo any of the procedures covered by their BCBS Massachusetts insurance plan are also required to utilize the following services: Open or Laparoscopic Biliopancreatic Bypass.The policy provides coverage for the following types of weight loss surgeries for qualified patients: Types of Weight Loss Surgeries Covered by BCBS Massachusetts In case the contract of the patient clearly states that weight management and/or obesity treatment have been excluded, the procedure will not be approved. The patient has to meet ALL of the conditions to be approved for bariatric surgery. Obesity should not be caused by any metabolic disorders.Attempts to lose weight led to failure and have been recorded.The patient has documented evidence of being morbidly obese for five years.The policy is also applicable if the patient is 100 pounds above or twice the ideal weight based on his/her age, sex, and height as measured against the Metropolitan Life Insurance Table. The patient should have a Body Mass Index of over 40 or over 35 if accompanied by weight-related illnesses like hypertension and diabetes.The policy of the patient must specifically include weight management or has obesity treatment as an advantage of the process.Patients have to be at least 18 years of age at the time of the surgery.To qualify for coverage of weight loss surgery under the BCBS Massachusetts policy, the following guidelines have to be met: BCBS Massachusetts – Pre-Approval Requirements If you have BCBS Massachusetts and don’t have coverage consider the state offered health plan. Massachusetts has some of the best state covered benefits for weight loss surgery in the country. To find out if your policy includes coverage, please talk directly to BCBS Massachusetts. ![]() However, not all policies include coverage. To qualify for coverage, your policy must include coverage. BCBS Massachusetts Covers Weight Loss SurgeryīCBS Massachusetts covers weight loss surgery.
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