Must meet one of the following three criteria:
1. Must have a minimum body mass index (BMI) of > 30 with a diagnosis of Diabetes Mellitus.
2. Must have a BMI of > 35-39 and must have at least one of the following conditions:
a. Degenerative joint disease of major weight bearing joint(s). The member must be
a candidate for joint replacement surgery if weight loss is achieved.
b. Other rare chronic conditions (for example, pseudo tumor cerebri) in which there
is medical evidence that bariatric surgery is medically necessary and that the
benefits of bariatric surgery outweigh the risk of surgical mortality.
3. Must have a minimum BMI of > 40
Here is their wording. I’m obviously number 3 I’m just worried it’s a case by case basis and they won’t approve me.
