Great Lakes Weight Loss uses the following criteria to determine whether or not you qualify for the lap band procedure: - Age greater than 18 years
- BMI greater than 35 (usually 50 or more pounds overweight)
- Well motivated and well informed about the significant lifestyle changes necessary
- No active substance abuse problems within the last year
- Are medically healthy enough to tolerate the procedure
Unfortunately, most insurance companies use a different set of criteria to determine whether or not they will authorize the procedure. Each insurance company is different, but most agree on the following criteria. - Body Mass Index (BMI) of over 40, or
- BMI of over 35 and have one or more of the comorbidities associated with increased weight.
- Most insurance companies expect the patient to provide written evidence that they are unable to achieve a healthy body weight for a sustained period of time through medically supervised dieting, usually in the form of a medically supervised period of diet.
If you qualify for the procedure, but do not meet the demands based on your insurance carrier, you must elect the self payment option. |