Surgical treatment of Morbid Obesity is limited to one (1) surgical procedure per Member per lifetime and must be performed by a Participating Provider and authorized in advance by WHP. Services for and related to surgical treatment of Morbid Obesity will only be Covered if the treated person is a Member and the services are Covered under a valid Rider and Exhibit 2 of this Agreement states that these services are Covered.
Surgical treatment of Morbid Obesity. Coverage is provided for surgical treatment of morbid obesity for one surgical procedure within a two-year period, measured from the date of the first surgical procedure to treat morbid obesity, unless a multi-stage procedure is planned, and We authorize coverage for such multi-stage procedure. In addition, We will cover surgery required as a result of complications that may arise from surgical treatment of morbid obesity. For the purpose of this coverage, morbid obesity means a body mass index that is greater than 40 kilograms per meter squared; or equal to or greater than 35 kilograms per meter squared with a high risk comorbid condition. Body mass index is calculated by dividing the weight in kilograms by the height in meters squared.
