Bianca_Moore8851 0 Posted December 29, 2018 I have Florida Blue BCBS *** I wonder do it covered the gastric sleeve surgery and I have sleep apnea and high blood pressure? Sent from my LM-X210(G) using BariatricPal mobile app Share this post Link to post Share on other sites
Walter Lindstrom 42 Posted December 31, 2018 Hi Bianca, There are some Florida Blue policies which do cover surgery (including the sleeve) and many which do not. So the big question is what certificate do you have? You can look it up on their portal as a Member but at least I can give you the link to their Medical Policy: Subject: Bariatric Surgery - Effective 12-15-2018 Here is their general criteria: Selection criteria (Adults) *Severely obese with a BMI ≥ 40 kg/m2, OR *Severely obese with a BMI ≥ 35 kg/m2, with at least one comorbidity refractory to medical management (e.g., type 2 diabetes, hypertension, coronary artery disease, obstructive sleep apnea, GERD, osteoarthritis, pseudotumor cerebri), AND Does not have a medically treatable cause for obesity (e.g., thyroid or other endocrine disorder), AND Has made multiple attempts at non-surgical weight loss (e.g., diet, exercise, medications), AND Has received psychological or psychiatric evaluation with counseling as needed, prior to surgical intervention. Good luck! Hope this helps. Happy New Year! 2 Bianca_Moore8851 and LadySin reacted to this Share this post Link to post Share on other sites
Bianca_Moore8851 0 Posted January 1, 2019 Hi Bianca, There are some Florida Blue policies which do cover surgery (including the sleeve) and many which do not. So the big question is what certificate do you have? You can look it up on their portal as a Member but at least I can give you the link to their Medical Policy: Subject: Bariatric Surgery - Effective 12-15-2018 Here is their general criteria: Selection criteria (Adults) *Severely obese with a BMI ≥ 40 kg/m2, OR *Severely obese with a BMI ≥ 35 kg/m2, with at least one comorbidity refractory to medical management (e.g., type 2 diabetes, hypertension, coronary artery disease, obstructive sleep apnea, GERD, osteoarthritis, pseudotumor cerebri), AND Does not have a medically treatable cause for obesity (e.g., thyroid or other endocrine disorder), AND Has made multiple attempts at non-surgical weight loss (e.g., diet, exercise, medications), AND Has received psychological or psychiatric evaluation with counseling as needed, prior to surgical intervention. Good luck! Hope this helps. Happy New Year!Thank You Happy New Year's To AlsoBianca Share this post Link to post Share on other sites