It is not particularly difficult for most people to get approved for bariatric surgery, but there are some steps one usually must go through. In the United States, bariatric surgery is considered medically necessary, and so it is a covered benefit by most public and private health plans. This includes Medicare, government plans, and military plans like TRICARE, most state Medicaid plans, and most commercial insurance plans that go through people’s employers. There are still exceptions, as some plans and employers appear to be living in the Dark Ages and do not think obesity and type two diabetes deserve treatment. But these are growing fewer every year. Having said that, all the plans require that people jump through some hoops to qualify. Let’s review.
Qualifying For Bariatric Surgery
The hoops have become a little bit easier in recent years because many of the required appointments can now be done via Zoom. This is one of the positive side effects of the Covid pandemic, teaching all of us that we can accomplish a lot of tasks effectively on Zoom calls and not necessarily in person. Nonetheless, most plans require several months of regular appointments for education regarding diet and weight management, evaluations by a nutritionist and psychologist, and possibly some additional steps outlined by the surgical practice. At our center, these additional steps include an x-ray or endoscopy of the stomach area to evaluate the anatomy and avoid any surprises. It may also include the kind of routine laboratory and x-ray studies almost everyone gets with surgery, just to ensure safety.
Think of all those steps listed on a checklist. Once a person has checked all the boxes and completed all the steps, usually the approval is not difficult. It is just a matter of sticking with all those steps.
Once that approval comes, then the surgery can be scheduled. At most centers, that procedure will be a minimally invasive procedure meaning laparoscopic or robotic with small cuts and small Band-Aids. About 70% of people undergo a sleeve procedure, and the remainder have some kind of bypass, either gastric bypass or duodenal switch. In the case of the sleeve, that might be a 30- or 45-minute procedure with an overnight hospital stay and an unparalleled safety record.
The Takeaway
Slowly but surely, we are moving towards the world in which bariatric surgery is more widely available with fewer hoops to jump through, and for a wider number of people. The years of life gained and the improvements in quality of life experienced by this greater access to bariatric surgery are immense. If your loved one struggles with obesity or type 2 diabetes, learn about the options and coverage available; it might be life changing.
Contact the team at Nevada Surgical today to get started.
