Yes, Blue Cross Blue Shield Covers Lap Band Surgery
Posted by Lori on March 14, 2008
I think that’s the search I’m seeing turn up more than any other. At the Centennial Center For The Treatment For Obesity, they have the criteria for lap band treatment for Blue Cross/Blue Shield in Alabama, Arkansas, Federal Employees, California, Florida, Georgia, Texas, Anthem (Kentucky, Virginia, Wisconsin, Ohio), Empire, Missouri, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, North Carolina, New York, Pennsylvania, Independent Blue Cross Pennsylvania, South Carolina, Tennessee, State Of Tennessee Employees, Tennessee – St. Thomas and Baptist Hospital Employees, Regence (Washington), Mountain State (West Virginia), and Highmark (Pennsylvania). As well as CHA Health, United Healthcare, Aetna, Unicare, Medicare, Definity Health, Cigna, Humana, Humana Medicare Gold Choice, Healthspring PPO, Healthspring Medicare Plus, CHAMPVA – Tricare or Champus, Tricare Standard, First Health, TennCare Bluecare, TennCare Select, AmeriGroup, Tenncare Americhoice and Great West Healthcare. They add new companies as they get them so I might not have all of them listed. Scroll to the bottom of the page, and you will see a PDF link for every company they cover.
If this is one of the first websites you’ve been to and you’re trying to figure out if you qualify, the basic standard for most insurance companies is a BMI of 35 with co-morbidities (diabetes, high blood pressure, high cholesterol or sleep apnea), or a BMI of 40, and documented attempts at weight loss. And then each program will have their own little particulars. The criteria can change as well, so just take it as a guideline.
If you need to calculate your BMI, you can do so here at the bottom of the page. For instance, a guy who is 5’11” and weights 275, would have a BMI of 38 – so he would need some co-morbidities to have it covered. His ideal weight would be 165, so he could conservatively expect to lose 77 pounds. A woman who is 5’5″ and weighs 250 would have a BMI of 42 so she wouldn’t need the co-morbidities. Her ideal weight would be 138 and she could conservatively to lose 78 pounds with a lap band.
Sorry for the boring post. Just wanted to put it out there for all the link-a-phobics looking for quick answers.