Candidate Requirements
In order to qualify as a weight-loss surgery candidate, you must meet certain Body Mass Index (BMI) requirements. The Metabolic & Weight Management Center follows the National Institutes of Health (NIH) guidelines when considering a patient for weight-loss surgery. View our patient packet here.
Surgical Pathway Checklist
You are a possible candidate for bariatric surgery if:
- Your BMI is 40 or higher
- Your BMI is between 35-40 and you have comorbidities, such as high blood pressure or diabetes
- Your BMI is 30–34.9 and you have select circumstances such as uncontrolled Type 2 diabetes, consistent with current professional society recommendations
- You are between 18 - 70 years of age
Pre-Surgery Process
Before undergoing surgery, there are several steps you must complete to ensure you have the best possible experience. The first step is to complete the online information session. Once we receive your information packet, you will be contacted by one of our staff members to move forward with the program. Surgery is usually performed an average of 12 weeks after the completion of our free online seminar.
Consults
You will complete your initial consults with our registered dietitian and behavioral health coach. After these are completed, your surgical consultation will be scheduled. The purpose of these consults is to discuss realistic goals and walk you through each step of the process to ensure you have the best possible outcome.
Medical Clearances
To move forward with surgery, we may require you to obtain medical clearances per your surgeon's instructions. We will assist you in scheduling any necessary clearances, which may include a cardiac, pulmonary or internal medicine consultation.
Post-Surgery Process
Our staff work closely with patients to monitor the recovery process. The first two-weeks after surgery, you will receive a phone call from one of our nurses to ensure you're doing well and are on track for recovery. Patients also have lifetime access to support groups.
Two Weeks After Surgery
At two weeks, you will have your first in-office visit with the surgeon and dietitian. You will be weighed and have your incisions checked. Your surgeon will also evaluate your diet and see if it can be advanced.
Four Weeks After Surgery
At four weeks, you will have another in-office visit for a routine checkup. Staff will assess your dietary intake, how your surgical wounds are healing and obtain weight and biometric measurements.
You will have routine follow ups for life including at 3, 6, 9, 12, 18 and 24 months and annually thereafter with the option of in-person for weight checks and telehealth including group medical visits that include participation from a surgeon, dietitian and behavioral health.
Paying for Surgery
Insurance
We accept all private insurances. We do not accept Medicaid or Ambetter. All insurance carriers and policies have different coverage guidelines and exclusions. We will be happy to contact your insurance company to determine coverage criteria. If you do not have insurance coverage for this procedure, we have a self-pay option.
Generally, insurance plans require you to meet the following criteria for weight-loss surgery coverage:
- BMI of 40+ or 35 with a related health condition
- Documented history of medical weight loss attempts
- Between two and five years of a high weight and weight-related concerns
- Psychological evaluation
- Nutrition counseling
- Additional insurance requirements may include a documented three to six-month medically supervised diet and blood test to rule out a thyroid disorder or other possible diseases
While insurance will cover most of the cost of certain bariatric surgeries, we will discuss your benefits with you, answer any questions you might have and let you know about any items that may not be covered by your insurance (e.g., out-of-pocket fees, co-pays and/or deductibles). Tricare now covers the sleeve gastrectomy procedure (gastric sleeve) for beneficiaries and their dependents.
Self-Pay
While most insurance plans cover weight-loss surgery, we understand some may not. In these instances, we offer a self-pay option with a competitive rate.
Financing
Taking on the payment or co-payments for these surgeries is a big investment in your health. We do require payment at the pre-operative visit from all our bariatric surgery patients for self-payment. Although we do not offer financing, our patient navigators will be happy to discuss other payment options during your consultation.
