Bariatric Surgery and Medicare

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Bariatric Surgery and Medicare

For older patients who are contemplating the prospect of weight loss surgery, it is helpful to learn about the finer details of bariatric surgery and Medicare. Bariatric surgery can be quite expensive depending on a few choice circumstances, so eyeing ways to help lower the cost can significantly improve your likelihood of getting the surgery. In this post, we will review the finer points of bariatric surgery and Medicare so you can assess your eligibility for getting financial assistance.

The following are the qualifications that must be met before a patient can hope to have access to financial support from Medicare. It should be noted that all of these considerations will have to be met together collectively. Failure to meet at least one of these considerations will mean no support from Medicare.

The patient should have a Body Mass Index of at least 35. The Body Mass Index is a ratio of a patient’s weight and height and is indicative of how much extra weight does a patient have relative to his or her weight. A BMI of 35 indicates that a patient is about 80 pounds above his or her target weight.

The patient should be suffering from at least one co-morbidity which is an illness that is known to be aggravated by excess weight. Common examples include diabetes, sleep apnea or heart disease. The patient should have his or her doctor’s certification to prove that the patient is suffering from one of these conditions.

Medicare will also require documentation to prove that effort has been made to lose weight via supervised diet and exercise programs without any effect. Medicare will not accede to paying for bariatric surgery if it is considered as a first option instead of as a last resort following many other occasions where normal weight loss procedures have been tried.

Consequently, Medicare also requires that all other weight loss treatment procedures have been ruled out for the patient. As a point of emphasis, weight loss surgery should be considered as a last resort, not an easy-way-out for people with weight loss problems.

Bariatric surgery and Medicare also requires a thorough psychological evaluation to ascertain the mental state of the patient prior to the procedure. The rigors of weight loss surgery exert a high level of stress on patients owing to its complexity so it is important that the patient is in a sound mental state prior to undergoing the procedure.

As a last requirement, Medicare requires that the procedure to be performed is approved by Medicare. Moreover, the procedure should also be conducted in a facility accredited by Medicare. Medicare will not pay for a procedure performed in other venues even if a patient has complied with all other criteria listed above.

The bariatric surgery and Medicare connection is essential to help patients with financial limitations overcome their circumstances in their pursuit of a healthy lifestyle. As long as the above conditions are duly met, one can expect to have the support of Medicare to pay for the procedure, in-part or in-full, and that will go a long way towards helping a patient finally make the life-changing step to health and wellness.