Question:
where do I start & what is consider to qualify for surgery

Because I'm just starting out I would like to know how hard it's going to be to get approved and what I need to do to prove the surgery is necessary.    — Amy K. (posted on February 29, 2004)

February 29, 2004
You need to find out what your insurance requires. A lot of them are requiring at least 6 months of a dr supervised diet. There are other requirements, but it all depends on your insurance. A bmi of 40 or above or 35 and above with comorbidities. Start with insurance requirements.
   — jaetex

February 29, 2004
Amy, I agree with Janelle. First, I would call your insurance carrier to see if they cover the procedure you want to have done. On this site there is the section called "Your Journey". It will give you the procedure codes which you can give your insurance company to see if they cover it. Don't just call and say you're interested in gastric bypass. Have the codes and see if it's covered. It it is, my next suggestion as a follow up is to come back onto Obesity Help and see what the approval process is like for your insurance company by clicking on the "insurers" section of this site and see what's happening in your area. Then, make an appointment with your doctor if you need to get a referral for a surgeon. Research the surgeons in your area that do the procedure you want to have done, check to see if they accept your insurance, and give the name of the surgeon you want the referral to your primary doctor. If you don't need a referral, call the surgeon of your choice and make an appointment. Don't be surprised if the surgeon doesn't have any open appointments for a month or two down the line. Some are very busy. Most of all, be patient during this entire procedure. It won't happen overnight and depending on your insurance and how busy your surgeon is, it could take a while. But if you're serious, you'll find the patience to wait. Good luck.
   — antiques55