Bariatric Surgery Is Not a Covered Benefit For Colorado
November 20, 2013Last month I attended my local Medical Society’s meeting in Denver. The title of the meeting was, “The New Insurance Exchange—What Physicians Need to Know.” Representatives from Connect for Health Colorado, the CO Division of Insurance, and Denver Public Health were on the panel to help explain how the insurance coverage under the Affordable Health Care Act will work, and how it will affect physician practices and health plan contracts.
During the Q&A session I relayed a question from one of my patients to the panel: “Which plan on the exchange covers bariatric surgery?” According to one of the panel members, “This is not a platinum insurance program. If someone wants that kind of plan, they can purchase it outside the exchange.”
With the rising incidence of obesity, and new evidence showing that Bariatric Surgery (gastric bypass, duodenal switch, sleeve gastrectomy, and lap banding surgery) has the potential to improve or even cure diabetes, high blood pressure, sleep apnea, high cholesterol, and heart disease, it seems odd that our state-funded health insurance does not cover such a vital service. Medicare and Medicaid cover bariatric surgery, as do most of the commercially available plans offered through large corporations.
The Colorado Insurance Exchange ostensibly exists to fill the gaps for patients that have previously been uninsured. These Coloradoans, statistically, have a higher incidence of diabetes and the other health problems listed above. So why doesn’t the Exchange cover these life-saving procedures?
 | ABOUT THE AUTHOR Matthew Metz, MD, FACS is a board-certified, Cleveland Clinic trained, Bariatric Surgeon practicing with the Denver Center for Bariatric Surgeryin Colorado. Dr. Metz has performed thousands of bariatric surgeries and is well known in the area for his kind demeanor, technical proficiency, and compassionate bedside manner.Read more articles by Dr. Matthew Metz! |
