Unless otherwise noted in your insurance, Humana does cover weight loss surgery. Humana, in fact, has a bariatric management team. The Bariatric Management Team is here to assist you with your weight reduction surgery. In addition, the staff is accessible for up to 6 months after surgery. They can help you deal with any post-surgical issues that may arise.
Weight loss is achieved through two main mechanisms: caloric intake reduction and energy expenditure increase. Weight loss medications may be used to reduce appetite or treat other conditions such as diabetes or high blood pressure. Lifestyle changes such as eating less food and moving more often will naturally lead to weight loss. Surgeries are considered when other methods have failed or are not an option. Surgical procedures can be divided into three categories: restrictive, malabsorptive, and metabolic.
Restrictive surgeries reduce the amount of space within the stomach cavity, thereby allowing a person to eat less food but still feel full. These procedures include laparoscopic adjustable gastric banding and open gastric banding. After these operations, patients need to adjust to eating only small meals frequently because squeezing a large meal into a limited space will not work.
Malabsorptive surgeries remove part of the intestine. The remaining portion of the intestine adapts by growing longer and thicker walled cells to absorb nutrients from the food we eat.
If you're thinking about having bariatric surgery and want your health insurance to cover it, you may have to go through some hoops. It is typical to encounter health insurance companies that will not pay for weight-loss surgery while yet paying for years of treatment for obesity-related diseases. However, this does not mean you cannot be treated for obesity-related diseases or that you will not receive financial assistance. You may need to find a surgeon who will perform the procedure despite no cash value being placed on thinness.
In fact, many surgeons will waive their fees if you can prove you are unable to pay. They might do this because they don't want to scare off potential patients or because they believe that suffering from obesity should not prevent you from getting necessary care. Some insurers also offer assistance with costs after the procedure has been performed. If you feel you require weight-loss surgery, contact your insurer before you schedule an appointment with a surgeon to discuss their coverage policies.
Vertical sleeve gastrectomy (gastric sleeve) is the most common kind of weight reduction surgery now performed in the United States, followed by Roux-en-Y gastric bypass surgery, laparoscopic adjustable gastric banding (LAP-BAND or REALIZE Band), and biliopancreatic diversion with duodenal switch. In Europe, gastric bypass has become the most popular procedure used to treat obesity.
The American Society for Bariatric Surgery estimates that about 150,000 people in the United States have had some form of weight reduction surgery.
Almost all patients lose weight after surgery and about 80 percent achieve a weight less than what they started with. However, 50 years or more after their surgeries, many patients still experience abdominal pain, irritability, or other symptoms related to malnutrition. As with any major surgery, there is a risk of mortality associated with weight reduction surgery.
Weight loss surgery prevents absorption of nutrients from food as much as 75% after gastric bypass surgery and 95% after vertical sleeve gastrectomy. This leaves the patient feeling hungry and unable to eat enough nutritious food to meet their body's needs. People who have had weight loss surgery may need special nutrition counseling after their surgery to learn how to choose foods that will help them maintain their weight after their operation.
Over time, the stomach loses muscle tone and can't control its emptying process. Therefore, the patient is at risk for developing nutritional deficiencies post-surgery.
To be considered for weight-loss surgery, you must satisfy the following criteria: Have a BMI of 40 or above, or a BMI between 35 and 40 combined with an obesity-related disorder such as heart disease, diabetes, high blood pressure, or severe sleep apnea. The surgeon may also ask you to try other treatments first. These could include changing your diet by eating less food and more nutritious items or using a gastric balloon to reduce how much you eat.
Many health insurers cover the cost of weight-loss surgery. You can find out if yours does by contacting your insurer directly or visiting its website. If your insurer doesn't cover it, look into other options for financing your surgery. In some cases, patients have been able to take out personal loans or credit cards to pay for their surgery.
The amount of time it takes to recover from weight-loss surgery varies for each patient. Some people report feeling better right away while others may not feel fully recovered for months or years after their surgery. After surgery, it is important to follow up with your doctor so that any post-surgical complications can be identified early on.
Many PPO insurance companies now cover gastric sleeve, gastric bypass, distal bypass, and lap-band removal. Weight loss operations are commonly covered by Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare, and United Health Care. In some cases, you may have to provide evidence of weight loss as well as comply with other conditions before your operation will be approved.
In addition to insurance coverage, there are also resources available that can help cover the cost of weight loss surgery. The National Institutes of Health has an award called the Obesity Surgery Funding Program that provides support to research projects related to bariatric surgery. This program was created in 2008 and up to $10 million is distributed each year. There is also a surgical funding program called Bariatic Surgery Financial Assistance (BSFA) that was established by Congress in 1992. This program offers financial assistance to patients who meet certain requirements such as being uninsured or underinsured, having a household income below a specified amount, or being a veteran or active duty military member.
Weight loss surgery is considered medically necessary if you have been obese for a long time and high blood pressure, diabetes, or other health problems are associated with your weight. Your doctor will determine whether or not the benefits of surgery outweigh the risks. Some potential complications include infection, bleeding, bowel obstruction, heart attack, and pulmonary embolism.
Assuming you satisfy the requirements below and have no medical conditions that preclude you from having surgery, Medicaid will fund weight loss surgery. You must fulfill the standards listed below in order for Medicaid to fund the cost of your operation and any accompanying surgeon visits. These requirements vary by state but usually include being younger than 55 years old, having enough income to qualify for financial assistance, and showing that weight loss surgery is the best option for improving your health.
It is not always necessary or desirable to lose all of your weight before you have surgery. Your doctor will work with you to determine an appropriate amount to lose prior to surgery. Generally, you should lose at least 10% of your total body weight in order to reduce your risks significantly. However, some patients are able to achieve satisfactory results with as little as 5%.
Your weight loss may be achieved through behavioral changes such as eating less and moving more or using prescription drugs. After weighing your options, your physician will help you decide what course of action is right for you.
Medicaid covers a lot of ground when it comes to obesity treatment. It can pay for counseling, programs in schools, groups, and clinics. There are even mobile services that will come to your home if needed. The benefits are endless! If you're eligible for Medicaid, call around to different surgery centers to see which one offers you the best deal.