Medi Cal doesn’t cover weight loss surgery. For a procedure to be covered under Medi Cal, it must be medically necessary, which is defined as a procedure, treatment, or medication that the medical community accepts as a needed intervention for a specific condition. This is a very specific definition, and weight loss surgery is not typically seen as medically necessary for the treatment of obesity. Medi Cal does, however, cover bariatric surgical procedures, such as banding or bypass, for the treatment of morbid obesity. In order to qualify for this, you must have a BMI of 50 or above, or a BMI of 40 or above if you have a serious health risk related to your weight. If you don’t meet these qualifications for Medi Cal, you may be able to have the procedure through a private insurer. There are a variety of things to consider, so you should speak to your doctor or a specialist as soon as possible..
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Does Medi Cal Cover Weight Loss Surgery? – Related Questions
How do I get bariatric surgery with Medi Cal?
“As of July 1, 2014, Healthy San Francisco will no longer cover the full cost of the surgery; instead, it will pay for about 25% of the cost. For example, if the total cost of the surgery is $20,000, Medi-Cal will pay $5000 up front, and the patient will be responsible for the remaining $15,000. However, Medi-Cal will pay $5000 of the $15,000 balance, so the patient will only need to pay $5000.”.
How long does it take for medical to approve weight loss surgery?
Medical approval for weight loss surgery can take anywhere from a few weeks to a few months. The time required varies based on a number of factors, such as: Where you live: You might think that it’s easier to get approval for weight loss surgery in a big city, but it’s actually easier in some rural areas. A rural hospital might have less bureaucracy and more open-minded staff, which can lead to faster approvals..
What medical conditions qualify for weight loss surgery?
According to the American Society for Bariatric Surgery (ASBS) guidelines, here are some of the most common medical conditions / diseases which qualify for weight loss surgery: Osteoarthritis Obesity Acute Otitis Media Obesity Hypoventilation Syndrome Obesity Idiopathic Addison’s Disease Obesity Hypothyroidism Obesity is a disease Obesity Is a disease Obesity is a disease Obesity is a disease.
Does Medicaid cover fat removal?
No. Medicaid covers the cost of some fitness-related services, but not fat removal. Nor does Medicare. For example, Medicare covers fitness-related expenses like cardiac rehabilitation, pulmonary rehabilitation, and physical therapy. It also covers fitness-related preventative services like Personalized Preventive Plan (PPP) and annual wellness visits. But Medicare does not cover cosmetic plastic surgery like fat removal. Neither do Medicaid or any other health insurance plans. Medicaid, the federal/state health insurance program for people who are disabled or impoverished, covers some preventative services like colorectal cancer screening. But again, it does not cover cosmetic plastic surgery..
Can I buy insurance for bariatric surgery?
Yes. Many insurance companies offer coverage for bariatric surgery. In fact, this type of surgery is considered “medically necessary” so many health insurance companies will cover it. If you have a high-deductible insurance plan or a Medicare Advantage plan, you may have to pay a portion of the surgery costs up front until you reach your deductible or maximum out of pocket amount. Don’t let this deter you from moving forward with the surgery..
How many pounds overweight for gastric sleeve?
A person with a body mass index (BMI) of ___ is eligible for gastric sleeve surgery. A BMI is a number calculated from a person’s weight and height. Because BMI does not directly measure body fat, it is not a perfect tool. For example, athletes and body builders with very significant muscle mass can have a high BMI without much fat. But for most people, BMI is a useful screening tool. If your doctor is recommending weight loss surgery, it is likely that your BMI is over ___ ..
How do I get approved for weight loss surgery?
Getting approval for weight loss surgery can be a very lengthy process, but it doesn’t have to be as painful as you think. In order to get approval for weight loss surgery, you should visit your primary care physician as well as a nutritionist to establish a healthy weight loss plan. From there, you should research your surgeon thoroughly, as he or she will play a huge role in the long-term success of your weight loss plan..
How much weight do you have to lose before bariatric surgery?
I have had three surgeries since the first on March 30, 2008. I weigh 18 pounds less now than I did then! I am about to have the fourth surgery. I have been 239 pounds, 220 pounds, 197 pounds, and 157 pounds. I am 5’2″, and I am now 147 pounds. My doctor says I can lose another 10 pounds. I am already on a diet of only 800 calories a day..
How much does it cost for weight loss surgery?
The price of gastric sleeve surgery is usually around $6000. In most cases , the surgery is covered by health insurance. In fact , with the rising obesity rate in this country, insurers have begun covering more weight loss surgeries in recent years..
Do I qualify for lapband surgery?
In order to qualify for bariatric surgery , you need to have a body mass index of 40 or more, or a BMI of 35 or more with a serious comorbidity such as diabetes , sleep apnea , heart disease, or hypertension. If you do not have a BMI of at least 40, you may not qualify for surgery and will need to lose weight through a program. If you do not have a BMI of at least 35, you may not qualify for surgery and will need to lose weight through a program..