Does Wellcare of Ky Cover Weight Loss Surgery Form
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People also ask
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Is it hard to get approved for weight loss surgery?
To be eligible for weight-loss surgery, you must meet the following requirements: Have a body mass index (BMI) of 35 or higher, or have a BMI between 30 and 35 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea.
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How to get your insurance to cover weight loss surgery?
Common requirements are: Over age 18 (Some plans allow for surgery under age 18) BMI over 40 or BMI over 35 with high blood pressure, type 2 diabetes, or other risk factors. Documented weight loss efforts over a period of time. Weight loss program mandated by the insurance company. Psychological testing.
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Does Kentucky Medicaid pay for weight loss surgery?
- Bariatric Surgery will be covered only if it is medically necessary and prior authorized. Note: Services for the treatment of obesity (including gastroplasty and gastric stapling) are generally not covered by KY Medicaid.
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Why is weight loss surgery not covered by insurance?
Insurance approval criteria Insurance requirements to cover a weight loss surgery can vary from plan to plan, so it's important to check yours. Some common criteria include: an elevated body mass index (BMI) health complications like hypertension, cardiovascular disease, or diabetes.
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Why would insurance deny weight loss surgery?
Payment may be denied because there may be a specific exclusion in your policy for obesity surgery or "treatment of obesity." Such an exclusion can often be appealed when the surgical treatment is recommended by your surgeon or referring physician as the best therapy to relieve life-threatening obesity-related health ...
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Does WellCare cover weight loss medication?
The following drugs are prohibited by law from being included on a Medicare Advantage or Medicare Part D formulary: Drugs to treat anorexia, weight loss or weight gain. Fertility drugs. Medications taken for cosmetic purposes.
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What is considered medically necessary for weight loss surgery?
In general, bariatric surgery could be an option for you if: Your body mass index (BMI) is 40 or higher, called extreme obesity. Your BMI is 35 to 39.9, called obesity, and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea.
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How to get weight loss surgery approved by insurance?
Common requirements are: Over age 18 (Some plans allow for surgery under age 18) BMI over 40 or BMI over 35 with high blood pressure, type 2 diabetes, or other risk factors. Documented weight loss efforts over a period of time. Weight loss program mandated by the insurance company. Psychological testing.
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