The growing obesity epidemic 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 procedure, their experience is varied.

The Blue Distinction Centers for Bariatric Surgery consist of identified hospitals that meet a broad range of criteria, focusing on experience and surgical outcomes. Use of such centers has typically improved health outcomes and financial performance by lowering complications.

Members of Blue Cross and Blue Shield of Texas may take advantage of the Blue Distinction Centers for Bariatric Surgery. Members using the Blue Distinction Centers or Blue Centers have to meet medical necessity criteria for the surgery. See the section Medical Policy – Bariatric Surgery.

Those who are not members of Blue Cross and Blue Shield of Texas should contact their own health plan (the information on this website may not apply to them).

The selection of providers for the Blue Distinction Centers began with a 27-page Request for Information (RFI). The RFI elicited detailed information about qualifications and experience from each hospital as well as their surgical success rates and complications.

A review committee conducted a blind analysis of the RFI results based on defined clinical criteria and acceptance letters were sent to the selected hospitals.

BCBSTX member participation is voluntary. Members whose benefit plan includes coverage for bariatric surgery will be advised of the Blue Distinction Centers for Bariatric Surgery; however, depending upon the member's benefit design, the member may be able to choose other contracted facilities without penalty. The member must complete a medical weight management program and satisfy all other criteria in the medical policy regarding Surgery for Morbid Obesity before bariatric surgery can be considered. When using a Blue Distinction Center for Bariatric Surgery members should confirm that the surgeon is part of the contracting network by calling Customer Service. Members will not receive in-network benefits for the services of surgeons or other providers who are not in the contracted provider network of the member’s health plan.

The HMO program follows a different procedure than that described above. HMO members need to consult with their Primary Care Physician regarding the most appropriate treatment for their condition.

Check the Blue Cross and Blue Shield Association's list of Blue Distinction Centers for Bariatric Surgery . Before making an appointment, members need to call BCBSTX Customer Service to verify plan coverage for services, and to confirm the provider's network participation status as a Blue Distinction Center.