Coverage Policy For Weight-Loss Surgery
Medical News Today, 16th February 2009
Not every weight-loss procedure can be covered by insurance. Medicare and Medicaid Services have just clarified only batriatic surgery which cures patients with type 2 diabetes will be covered.
Medicare explains the decision by type 2 diabetes being one of the most common reasons of pre-mature deaths. In this case, weight-loss operation is very often a life-saving procedure. Morbidly obese patients have body mass index (BMI) of 35 or more. Normal BMI is between 18.5 and 25.
“Medicare beneficiaries who are morbidly obese may face tremendous health complications,” said CMS Acting Administrator Charlene Frizzera. “Today’s coverage decision assures that beneficiaries who are morbidly obese can access safe, effective weight loss options to help prevent these complications.”
The decision means that Medicare will not cover procedures for patients with a BMI below 35, even though researches show that weight-loss surgery is helpful for these patients. Medicare, though, did not find those findings convincing.
Batriatic surgery for Medicare beneficiaries has been expanded in 2006. It covered Pptients who received surgery from highly-qualified surgeons. In order to qualify for a weight-loss surgery covered by Medicare, these patientsā BMI had to be 35 or more and they had to experience serious health problems because of their obesity.
Four types of weight-loss surgery are covered: gastric bypass, open and laparoscopic Roux-en Y gastric bypass, laparoscopic gastric banding and open and laparoscopic biliopancreatic diversion with duodenal switch.
