Blue Cross and Blue Shield of Texas (BCBSTX) members and their providers will need to consult the member's health plan or contract to determine if bariatric surgery is covered. The health plan or contract defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The member must also meet certain criteria before being considered eligible for bariatric surgery to treat morbid obesity. BCBSTX Medical Policy defines these criteria.

To confirm coverage of benefits, members can call the Customer Service number on the back of their member ID card. If the health plan includes coverage for bariatric surgery and treatment, members and their providers will need to obtain preauthorization from BCBSTX before services are performed.

For help in determining if your patient is eligible for bariatric surgery and what procedures are covered, check the Medical Policy for Bariatric Surgery.