Does Blue Cross Shield of Florida cover bariatric surgery?

Yes, Blue Cross Blue Shield (BCBS) of Florida does cover bariatric surgery. However, the coverage and specific requirements may vary depending on your plan and policy. It's essential to check with your specific BCBS of Florida plan or contact their customer service department to confirm the details of your coverage. Here's some general information about BCBS of Florida's coverage for bariatric surgery:

1. Medical Necessity: Bariatric surgery is typically covered if it is deemed medically necessary for the treatment of severe obesity and related health conditions.

2. BMI Requirements: BCBS of Florida may require you to meet certain Body Mass Index (BMI) requirements to qualify for bariatric surgery coverage. The specific BMI threshold may vary, but it's generally in the range of 40 or higher, or 35 or higher with co-occurring health conditions.

3. Pre-Authorization: Prior authorization is usually required for bariatric surgery. You may need to obtain pre-authorization from BCBS of Florida before undergoing the surgery. This involves submitting medical records, documentation, and a treatment plan to demonstrate the medical necessity of the procedure.

4. Covered Procedures: BCBS of Florida may cover various types of bariatric surgeries, including Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding (AGB). The coverage for specific procedures might depend on your policy and individual circumstances.

5. Network Providers: BCBS of Florida may have preferred or network providers for bariatric surgery. Using these providers may offer more comprehensive coverage and reduce your out-of-pocket costs.

It's crucial to note that the information above is general and may be subject to change. For the most accurate and up-to-date information on bariatric surgery coverage, it's best to contact your specific BCBS of Florida plan or visit their website. They can provide you with detailed information about your policy's coverage, including any exclusions, waiting periods, and cost-sharing requirements.