Surgery to relieve the condition of advanced obesity.

For policyholders whose health insurance plan includes coverage for bariatric surgery, Blue Cross and Blue Shield of Texas has Blue Distinction Centers for Bariatric Surgery. Policyholders may access the Blue Distinction Centers for Bariatric Surgery for information about the procedure. However, policyholders can still choose to have surgery performed in a contracting facility other than the Blue Distinction Centers for Bariatric Surgery.

Obesity is a serious health concern. Requests for Bariatric Surgery are on the rise throughout the country. While many surgeons and hospitals are willing to perform this operation, their experience varies greatly. The Blue Distinction Centers for Bariatric Surgery has identified hospitals that meet a broad range of criteria, focusing on experience and surgical outcomes.

The selection process began with a Request for Information (RFI) developed in collaboration with the Blue Cross and Blue Shield Association (BCBSA). The RFI sought detailed information about qualifications and experience from each hospital as well as their surgical success rates and complications. A review committee, consisting of the Quality Management Medical Directors, conducted a blinded analysis of the RFI results. Based on defined clinical criteria, the Blue Distinction Centers for Bariatric Surgery were selected.

No. A policyholder who has the bariatric surgery benefit must still meet all of the clinical eligibility criteria in our Medical Policy on Surgery for Morbid Obesity .

In selecting Blue Distinction Centers for Bariatric Surgery, the qualifications, the sucess rates as well as the complication rates are considered.

Policyholder participation is voluntary. Although policyholders whose benefit plan includes coverage for bariatric surgery will be advised of the Blue Distinction Centers for Bariatric Surgery, depending upon the policyholder's benefit design, the policyholder may be able to choose other contracting facilities without penalty. When using a Blue Distinction Center for Bariatric Surgery, policyholders should confirm that the surgeon is part of the contracting network by calling Customer Service. Policyholders will not receive in-network benefits for the services of surgeons or other providers who are not in the contracted provider network of the policyholder’s plan. Of course, use of a Blue Distinction Center for Bariatric Surgery does not ensure a successful outcome.

A good way is to initiate contact with the hospital is using the phone number we provide. Many hospitals also have web sites dedicated to their Bariatric Surgery Programs. You will want to schedule an appointment with one of the bariatric surgeons in the hospital. Important: check that the surgeon is currently participating in the network that serves your particular plan. When visiting the surgeon’s office, request that the other physicians involved in your case also participate in your network.