Does La Care Cover Weight Loss Surgery

What Types of Weight Loss Surgery Does La Care Cover?

La Care 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 the amount of calories absorbed.

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 and the amount of calories absorbed.

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 and the amount of calories absorbed.

La Care also covers other weight loss surgeries, such as biliopancreatic diversion with duodenal switch, and endoscopic sleeve gastroplasty. These procedures are more complex and may require additional follow-up care.

La Care also covers pre- and post-operative care for weight loss surgery, including nutritional counseling, psychological counseling, and medical follow-up.

How to Qualify for Weight Loss Surgery Coverage Through La Care

If you are a member of La Care, you may be eligible for coverage of weight loss surgery. Weight loss surgery is a major medical procedure and is typically only covered by insurance when medically necessary. 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. These conditions include type 2 diabetes, high blood pressure, sleep apnea, and other serious health issues.

Second, you must have tried other methods of weight loss, such as diet and exercise, and have been unsuccessful. You must also have a documented history of obesity for at least five years.

Third, you must have a psychological evaluation to ensure that you are mentally prepared for the surgery and understand the risks and benefits.

Finally, you must have a physician referral and a pre-authorization from La Care. Your physician must provide documentation of your medical history and your attempts at weight loss.

If you meet all of these criteria, you may be eligible for coverage of weight loss surgery through La Care. It is important to note that coverage is subject to change and may vary depending on your individual plan. Be sure to contact La Care for more information about your specific coverage.

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