Choose your plan from the list at left. A summary of plan benefits and requirements will appear below.
Aetna
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete either 4 months consecutive medical weight loss with their family doctor, dietician, behavior health specialist, and an exercise program or 6 months cumulative with their family doctor and dietician.
website: http://www.aetna.com
Anthem
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. Although most Anthem plans do not require medical weight loss, some plans require the patient to complete 6 months medical weight loss with their family doctor and dietician, as well as provide a five year weight history.
Please note that all Anthem policies vary
website: http://www.anthem.com
Blue Cross Blue Shield of Minnesota
- BMI greater than or equal to 40 or BMI greater than or equal to 35 with documentation of a co-morbid condition such as:
- Hypertension
- Cardiovascular disease
- Degenerative joint disease
- Diabetes
- Documentation of at least two years with the condition of morbid obesity
- Must have a documented medical history of failure to sustain weight loss with medically supervised diet
- and conservative treatment for at least one year preceding surgery
- Coverage may be available for Roux-en-Y or lap assisted gastric band
website: http://www.bluecrossmn.com
Federal Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete 3 months consecutive medical weight loss with their family doctor and dietician. The patient must also provide a note of medical clearance from their family doctor, as well as documentation such as nicotine levels, to show the patient has not smoked for at least 6 months prior to submitting to insurance for possible approval.
website: http://www.fepblue.org
Highmark Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete 6 months cumulative medical weight loss with their family doctor and dietician. During this time, the patient must participate in an exercise program such as Curves, Bally Fitness, YMCA, etc. and provide documentation each month.
- now requires consecutive Medical Weight Loss
website: https://www.highmark.com
Humana
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete 6 months cumulative medical weight loss with their family doctor and dietician, as well as providing a letter of support from their family doctor.
- now requires consecutive Medical Weight Loss
website: http://www.humana.com
Medical Mutual
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete 3 months consecutive medical weight loss with their family doctor and dietician, as well as provide a 1 year weight history.
website: http://www.medmutual.com
Medicare
Individual’s BMI must be at least 35 with at least one major health condition such as Diabetes, sleep apnea, hypertension, or severe arthritis.
website: http://www.medicare.com
Alabama Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without a major health condition. The patient must complete 6 consecutive months with their family doctor and dietician. The patient must also provide a 3 year weight history and a support letter from their family doctor, as well as documentation such as nicotine levels, to show the patient has not smoked for at least 8 weeks prior to submitting to insurance for possible approval.
Illinois Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without a major health condition.
Michigan Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete 6 months consecutive medical weight loss with their family doctor and dietician. If the patient’s BMI is 50 or greater, the patient is not required to complete medical weight loss.
Oklahoma Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without a major health condition. The patient must complete 3 cumulative months medical weight loss with their family doctor and dietician.
South Carolina Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without any major health conditions. The patient must complete 6 months consecutive medical weight loss with their family doctor and dietician, as well as provide a five year weight history.
Tennesee Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without a major health condition. Although there is not a specified number of months the patient must complete, the patient must meet with their family doctor and dietician and lose at least 10% of their body weight. The patient must also provide a 5 year weight history.
Texas Blue Cross Blue Shield
Individual’s BMI must be at least 35-40 with at least one major health condition such as Diabetes, sleep apnea, or hypertension or a BMI of 40 without a major health condition. The patient must complete 3 cumulative months medical weight loss with their family doctor and dietician.