• Age -You must be between the ages of 18 and 59.
• Body Mass Index (BMI) - You MUST have a BMI equal to or greater than 35.
• (This number is determined by your primary care provider or by using standardized
• BMI calculators that can be found on the internet.)
• Medical conditions/Comorbidities – You must have ONE of the following
• conditions:
1. Diabetes Mellitus and/or;
2. Degenerative Joint Disease of a major weight-bearing joint(s), such as knees or hips, and you need joint replacement surgery immediately as soon as weight loss is achieved.
3. Other rare co-morbid conditions (such as pseudo tumor cerebri) in which there is medical evidence that bariatric surgery is medically necessary and the benefits of bariatric surgery outweigh the risk of surgical mortality.
• You must NOT have multiple sclerosis (MS), which increases risk of mortality. (http://www.uwmedicine.org/services/weight-loss-surgery/Documents/DSHS-letter.pdf)
However, you will have to jump through many hoops to get it. Ok, not bad if it helps me feel better right? But how do you find out what the hoops are?
If you are like me you go to your primary care doctor let them know you want the surgery and ask what you need to do to get. And then they just stare out you or tell you to call Provider One. Once you wait anywhere from a half hour or more you get someone to talk to about it at the insurance company and they tell you only the doctor can request the information. So you get your doctor try calling them and they have to hang up after waiting 20 minutes. So now you are back to square one once again. So next thing to try is to call the bariatric surgeons in your area and see if they take your insurance. Wow, I hope you do not live in or near a big city you may be calling forever. One way to narrow the list down is to call any managed care plan you are on and ask them for a number of a surgeon. I was really lucky in trying this option. The first surgeon, the managed care, plan recommend gave me a number of a surgeon that did take the insurance. (If you live in the greater Seattle area and are looking for this information check out http://www.uwmedicine.org/services/weight-loss-surgery/Documents/DSHS-letter.pdf)
So my advice do not get discouraged if you are just hitting dead ends; if this will improve your health is not worth a little work?
