Morbid Obesity Surgery Sample Clauses

Morbid Obesity Surgery. The plan covers surgical treatment of morbid obesity provided all of the following are true: • You have a minimum Body Mass Index (BMI) greater than 40 kilograms per meter squared, or equal to or greater than 35 kilograms per meter squared with one of the following co-morbid conditions: ▪ Hypertension; ▪ A cardiopulmonary condition; ▪ Sleep apnea; or ▪ Diabetes. • You must enroll in the Optum Bariatric Resource Services (BRS) program, a surgical weight loss solution for those individual(s) who qualify clinically for Morbid Obesity Surgery. Covered participants seeking coverage for bariatric surgery should notify Optum as soon as the possibility of a bariatric surgery procedure arises (and before the time a pre-surgical evaluation is performed) at a bariatric surgery center by calling Optum at (000) 000-0000 to enroll in the program. • You have completed a multi-disciplinary surgical preparatory regimen, which includes a psychological evaluation. • You have a 3-month Physician supervised diet documented within the last 2 years.
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Morbid Obesity Surgery. The plan covers surgical treatment of morbid obesity provided all of the following are true: SAMPLE • For adolescents, you have achieved greater than 95% of estimated adult height AND a minimum Xxxxxx Stage of 4. • You have a minimum Body Mass Index (BMI) of 40, or > 35 with at least 1 co-morbid condition present. • You must enroll in the Optum Bariatric Resource Services (BRS) program, a surgical weight loss solution for those individual(s) who qualify clinically for Morbid Obesity Surgery. • You have completed a multi-disciplinary surgical preparatory regimen, which includes a psychological evaluation. • You have a 3-month Physician supervised diet documented within the last 2 years. • One surgery per lifetime unless complications. Excess skin removal post bariatric surgery is not covered, unless Medically Necessary.
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Morbid Obesity Surgery. Morbid Obesity Surgery must be received from a Designated Provider. Depending upon where the Covered Health Care Service is provided, Benefits will be the same as those stated under each Covered Health Care Service category in this Schedule of Benefits.
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Morbid Obesity Surgery. Morbid Obesity surgery must be received from a Designated Provider. Limited to one bariatric surgery per lifetime unless determined to be Medically Necessary to correct or reverse complications from a previous bariatric procedure. None Yes Yes
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Morbid Obesity Surgery. Morbid Obesity surgery must be received from a Designated Provider. 30% Yes Yes
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