qualifications for gastric bypass through neighborhood health plan

MelanieG
on 8/20/10 6:35 am - Goldsboro , NC
(asking for my sister)

what are the qualifications you have to meet to get gastric bypass under neighborhood health plan (with Masshealth secondary)
my sister (and i) have struggled with our weight our whole lives and my father has obesity related conditions (heart issues and diabetes) she is currently pre diabetic, is this enough to get her gastric bypass??

thank you so much.
    
Lynn C
on 8/21/10 10:09 am
the best source for this information is your insurance provider - call the number on the back of the card. Ask them if they cover WLS, if so which ones and what are the requirements. Most plans that cover wls require a BMI of 35 or more with 2 comorbidities or a BMI of 40 or more with none. Proof of prior weight loss attempts (some require doctor suppervised diets for 6 months - mine got through with my WW wheigh in records and a list of all the other diets I'd done).

this is what I found online  http://www.nhp.org/PDFs/Providers/NHP%20BariatricSurgeryPaymentGuidelines.pdf

Lynn C ~
Banded 9/12/2005 ~ Revision to VSG on 9/7/2010 ~ Losing again with a Keto lifestyle



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