Your policy must cover weight loss surgery in order to be eligible for coverage. Not all insurance policies provide coverage. Please contact Kaiser Permanente directly to find out if your policy covers you.
Weight loss surgery is covered by Kaiser Permanente. Kaiser Permanente covers gastric bypass, lap band, and gastric sleeve surgery if you satisfy the standards specified below.
How do you qualify for gastric sleeve with Kaiser?
Surgery is a tool for highly obese people who are unable to lose weight through other means. In most circumstances, Kaiser Permanente will support weight loss surgery if you meet the criteria listed below.
- Severe sleep apnea, high cholesterol, diabetes, and other comorbidities are examples.
- Within the last two years, you’ve completed a medically supervised weight loss program.
- For at least three of the last five years, I’ve been morbidly obese. A physician should document this (e.g., annual visits to your OB/GYN, etc.).
- A psychological examination was successfully performed. There are no concerns that will make sticking to your new diet and lifestyle post-surgery challenging.
Does Kaiser have a weight loss program?
If you need to lose at least 40 pounds and want to make positive, long-term changes that will: Improve your health, the Kaiser Permanente Medical Weight Management Program may be the right fit for you.
What can disqualify you from bariatric surgery?
There are some persons who are not candidates for obesity surgery for a variety of reasons. Your health comes paramount when determining eligibility, and your surgeon will assess the risks of significant weight gain against the surgery. You will not be considered if the procedure is likely to jeopardize your health or if the long-term health hazards outweigh the advantages.
A list of ‘contra-indications’ to surgery exist, which may indicate that you are not a good candidate for surgery. If you have any of the following symptoms, it does not mean you are ineligible for surgery; rather, it means you are in a higher risk category than others.
- Heart disease or serious lung issues in the past. These can make you more vulnerable to complications during anesthesia.
There are four items on this list, however, that if they apply to you, indicate that you are not a candidate for obesity surgery. They are as follows:
- Have you been diagnosed with Crohn’s disease or ulcerative colitis? (these are inflammatory bowel diseases).
Have a pre-existing disease that produces stomach or esophageal bleeding (windpipe).
Does Kaiser Cover skin removal after weight loss?
Oakland, California After a lengthy trial in a 10,000-member class action, a California state court judge concluded that Kaiser Permanente cannot systematically characterize the excision of excess skin following bariatric weight loss surgery as a cosmetic treatment, but that doctors might determine on a case-by-case basis.
What BMI qualifies for gastric sleeve?
Your body mass index, a numerical number of your weight in relation to your height, plays a role in determining your eligibility for bariatric surgery. The BMI range of 18-24.9 is seen as ideal. A BMI of 40 or higher is considered morbid obesity.
If you have a BMI of 35-39 with particular serious health concerns like Type 2 diabetes, sleep apnea, or high blood pressure, you may be a candidate for bariatric surgery. A BMI of 40 or more is also a requirement.
How quickly can I get bariatric surgery?
If there are no medical weight loss program restrictions, most patients can be pre-approved for bariatric surgery within 90 days/12 weeks (with consecutive office visits throughout), although there is no assurance. However, collecting the documentation and testing that the insurance company requires is one of the most significant bottlenecks in the insurance process. We keep you informed by interacting with you on a frequent basis during the pre-operative period.
Will Kaiser pay for Weight Watchers?
Employees and family members may be eligible for a 50 percent to 100 percent reimbursement, depending on their eligibility. For further information, call Kaiser Permanente’s HR Service Center at 877-457-4772.
How does the Kaiser diet work?
This diet should be followed for three days at a time. You can drop up to 10 pounds in three days. After three days, you can resume normal eating habits, but don’t overdo it. After four days of ordinary eating, you can resume the three-day diet.
What is the most successful weight loss program?
WWW (Weight Watchers) WW, originally known as Weight Watchers, is one of the most well-known weight-loss programs in the world. While there are no food restrictions, persons on the WW plan must eat within their daily point limits in order to reach their desired weight ( 57 ).
How do I get approved for weight-loss surgery?
You must meet the following criteria to be considered for weight-loss surgery:
- Have a BMI of 40 or more, or a BMI of 35 to 40 and an obesity-related ailment, such as heart disease, diabetes, high blood pressure, or severe sleep apnea.
- Weigh fewer than 450 pounds, which is the maximum weight allowed by hospital imaging equipment. A nutritionist can assist you if you need to lose weight to meet this criteria.
- Check to see whether your health insurance will fund bariatric surgery at UCSF if certain criteria are satisfied. Please be aware that we only accept Medi-Cal patients who are residents of San Francisco County.