![]() That’s why we complete a community health needs assessment every three years to identify and evaluate health related needs our community. We believe in improving the lives of those who call Yuma County home. Whether you have a common illness or need specialized treatment, our experts provide outstanding, personalized care. Yuma Regional Medical Center offers health services for all ages and aspects of life. Blue Cross New Jersey Horizon Contact Info to Inquire About SurgeryĬall Horizon Blue Cross Blue Shield New Jersey at 1-800-355-BLUE or visit their website to inquire about weight loss surgery.From newborns to grandparents, we’re dedicated to caring for your entire family when you need it most. It’s recommended to call one of the centers listed above and ask for a list of approved surgeons. Your surgery may have to be performed at a Blue Distinction Center. Using an in-network surgeon is not mandatory under most Blue Cross policies, but it results in lower out of pocket costs. Lourdes Medical Center of Burlington Countyĭo I Have To Use An In-Network Bariatric Surgeon?.Below is a list of approved centers in New Jersey for bariatric surgery: Does Horizon Blue Cross Blue Shield Require A Center Of Excellence?īlue Cross policies require a patient to have surgery at a Blue Distinction Center. The criteria for approving revisions are the same as that for repeat weight loss surgeries. The revision has to be considered medically necessary in order to be covered. Revisions are also decided on a case to case basis. Dilation of the gastric pouch or any other technical failure.Weight regain or inadequate (Proof of compliance with the postoperative dietary, exercise and lifestyle recommendations.The criteria for approval for a second weight loss surgery are: Important information required for making a decision include the patient’s BMI and documentation proving the procedure failed the first time. The medical director at Horizon Blue Cross Blue Shield New Jersey will analyze the application. Is A Second Weight Loss Surgery Covered If Lap Band Doesn’t Work?Ĭoverage for a second weight loss surgery is decided on a case to case basis. Mini-gastric bypass, gastric plication and other surgeries not listed above are considered experimental and not covered. These procedures are considered medically necessary for treating morbid obesity. Gastric Bypass with Long-Limb Roux en Y anastomosis.Gastric Bypass with Short-Limb Roux en Y anastomosis.Laparoscopic Adjustable Gastric Banding.Biliopancreatic Diversion with Duodenal Switch.Horizon Blue Cross Blue Shield New Jersey covers the following weight loss surgeries: Types of Weight Loss Surgeries Covered By Horizon Blue Cross Blue Shield of New Jersey The patient has to fulfill all of the criteria listed above to be approved for bariatric surgery. You can see a full list of co-morbidities here. The bariatric surgeon should submit the proper paperwork for approval.The patient should have a letter of recommendation from his/her primary doctor.Undergone pre-operative psychological evaluation and understands the impacts of weight loss surgery.Your surgeon will typically have these available. ![]() Participated in a surgery preparation program to enhance results and lower risk of complications after the procedure.Completed a weight loss program for at least six consecutive months.The patient, in the 12 months before the surgery, has to have:.The patient is morbidly obese (i.e., has a Body Mass Index (BMI) of over 40 OR has a BMI of over 35) with a life-threatening co-morbid disease such as:.Weight loss surgery for patients under 17 years of age is not considered medically necessary unless full skeletal growth has been reached, and the patient suffers from a co-morbid condition, such as sleep apnea or hypertension.The patient is at least 18 years of age, and the patient’s skeletal growth is complete.Weight loss surgery for treating morbid obesity is considered medically necessary if the patient fulfills the following criteria: Horizon Blue Cross Blue Shield New Jersey Pre-Approval Requirements Please note that not all policies include coverage. To qualify for coverage of weight loss surgery your policy must include coverage. Horizon Blue Cross Blue Shield New Jersey covers weight loss surgery.
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