Does Kaiser Hmo Cover Weight Loss Surgery

What Types of Weight Loss Surgery Does Kaiser HMO Cover?

Kaiser HMO covers a variety of weight loss surgeries, including gastric bypass, sleeve gastrectomy, and adjustable gastric banding.

Gastric bypass is a procedure that reduces the size of the stomach and reroutes the small intestine to a small pouch. This procedure helps to reduce the amount of food that can be consumed and absorbed, leading to weight loss.

Sleeve gastrectomy is a procedure that removes a large portion of the stomach, leaving a smaller stomach pouch. This procedure helps to reduce the amount of food that can be consumed, leading to weight loss.

Adjustable gastric banding is a procedure that places an adjustable band around the upper part of the stomach. This band helps to reduce the amount of food that can be consumed, leading to weight loss.

Kaiser HMO also covers other weight loss procedures, such as biliopancreatic diversion with duodenal switch, endoscopic sleeve gastroplasty, and endoscopic gastric balloon. These procedures are less common and may not be covered by all Kaiser HMO plans.

It is important to speak with your doctor and Kaiser HMO representative to determine which weight loss surgery is right for you and to understand what is covered by your plan.

How to Qualify for Weight Loss Surgery Coverage Through Kaiser HMO?

If you are a Kaiser HMO member and are considering weight loss surgery, you may be eligible for coverage. To qualify for coverage, you must meet certain criteria.

First, you must have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with one or more obesity-related conditions, such as type 2 diabetes, hypertension, sleep apnea, or joint pain.

Second, you must have tried other weight loss methods, such as diet and exercise, for at least six months without success.

Third, you must have a referral from your primary care physician and a consultation with a bariatric surgeon.

Fourth, you must have a psychological evaluation to ensure that you are emotionally and mentally prepared for the surgery.

Finally, you must attend a pre-operative education class to learn about the risks and benefits of the procedure.

If you meet all of these criteria, you may be eligible for coverage of weight loss surgery through Kaiser HMO. It is important to note that coverage may vary depending on your plan and the type of surgery you are considering. Be sure to contact your insurance provider to determine your specific coverage.

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