Does Masshealth Cover Weight Loss Surgery

by Patty Allen

Introduction

How much does gastric bypass surgery in NM cost? The average cost of gastric bypass surgery in New Mexico is $15,000 to $35,000. However, the cost may vary depending on the surgeon’s fees, hospitalization costs and anesthesia costs.

Who Qualifies for Gastric Sleeve in Massachusetts?

To benefit from this procedure, patients must have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher, as well as a medical condition such as type 2 diabetes, high blood pressure or sleep apnea.

What is a gastric band for weight loss?

Laparoscopic gastric banding is a surgical procedure to help with weight loss. The surgeon places a band around the top of your stomach to create a small pouch to hold the food. The group limits the amount of food you can eat by making you feel full after eating small amounts of food.

Does Blue Cross Blue Shield of NM cover bariatric surgery?

According to Blue Cross Blue Shield of New Mexico, most plans do not cover bariatric surgery. However, many states require coverage for single and family policies, and many employers have chosen to include it in their coverage.

How many kilos do you have to have to have a gastric sleeve?

Have a body mass index (BMI) of 35 or higher, or have a BMI between 30 and 35 and an obesity-related condition, such as heart disease, diabetes, high blood pressure, or apnea severe sleep. Weigh less than 450 pounds, the maximum weight the hospital X-ray equipment can support.

Why would you be refused bariatric surgery?

But why might a patient not qualify for bariatric surgery? BMI: First and most obvious, they may simply not have a high enough BMI. A BMI of 35 or greater with one or more obesity-related conditions or a BMI of 40 or greater regardless of obesity-related conditions is required to undergo surgery.

With what BMI can I have a gastric band?

To be eligible for abdominal surgery, patients must have a BMI of at least 40 (this usually translates to being 100 pounds or more overweight) or they must have a BMI of at least 30, be at least overweight less than 13.6 kilograms and suffering from at least one obesity-related comorbid health condition.

How long do gastric bands last?

Lap Band Complications

Numerous studies have shown that more than half of gastric bands are removed due to insufficient weight loss or complications after 7-10 years.

What BMI do you need for gastric banding?

You must be approved to undergo the Lap-Band procedure based on a number of criteria. Individuals eligible for abdominal surgery must: have a BMI of 40 or greater, OR have a BMI of 30 or greater and have obesity-related complications, such as type 2 diabetes. Be at least 18 years of age .

Does Medicaid cover the operation?

For surgical procedures, Medicare and Medicaid cover many medically necessary surgical services received both inpatient and outpatient. However, coverage terms may vary depending on the type of surgery performed, where it is performed and your particular situation.

Conclusion

Select a procedure below to view detailed cost data and vendor comparisons.
Procedure Price Range
Gastric Bypass Average Cost $16,100 – $44,200
Single Anastomosis Change Duodenal Change (SADI) Average Cost $17,800 – $48,800
Average gastric sleeve cost $11,600 – $31,900
Average duodenal change costs $21,000 – $57,600
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