Does Coresource Cover Bariatric Surgery?

Does Coresource Cover Bariatric Surgery?

Does Coresource Cover Bariatric Surgery? Bariatric surgery is a well-known method for achieving significant weight loss when other methods have not been successful. This surgical procedure is not only beneficial in terms of shedding excess weight, but it also helps improve various health conditions related to obesity, such as heart disease, high blood pressure, and type 2 diabetes. However, one of the primary concerns for many considering this procedure is whether their insurance will cover the cost.

Coresource, as a prominent health insurance provider, offers different coverage plans which may or may not include bariatric surgery depending on several factors. Understanding what your insurance covers can be a vital aspect of planning for bariatric surgery, as it can significantly impact the overall cost of the procedure. This article focuses on providing information about Coresource’s potential coverage for bariatric surgery.

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Understanding Bariatric Surgery

Bariatric surgery refers to a collection of procedures that are performed with the primary aim of helping individuals lose weight. This is typically considered for those who have a Body Mass Index (BMI) of 40 or higher, or a BMI of 35 or higher with associated health conditions related to obesity. The surgical methods include gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch. These procedures work either by limiting how much you can eat, limiting the absorption of nutrients, or both.

The first method, gastric bypass, involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. This procedure allows food to bypass a portion of the small intestine, which absorbs calories and nutrients. Having smaller stomach pouch causes individuals to feel full sooner than when their stomach was its original size. This results in reducing the amount of food intake and thus leads to weight loss.

Sleeve gastrectomy is another procedure that aids in weight loss by removing about 80% of the stomach, leaving only a tube-shaped portion of the stomach, known as a ‘sleeve’. This smaller stomach cannot hold as much food and it also produces less of the appetite-regulating hormone ghrelin, which may lessen your desire to eat. However, sleeve gastrectomy does not affect the absorption of calories and nutrients in your intestines.

Adjustable gastric banding is a type of restrictive weight loss surgery where a band containing an inflatable balloon is placed around the upper part of the stomach and fixed in place. This creates a small stomach pouch above the band with a very narrow opening to the rest of the stomach. This slows down the emptying into the larger portion of stomach causing a feeling of fullness.

Lastly, biliopancreatic diversion with duodenal switch involves reducing the size of the stomach and removing part of your small intestine to limit food intake and reduce nutrient absorption. It is typically performed as a last resort for people who are extremely obese and have tried other weight loss methods without success.

Each one of these bariatric surgeries has its own set of benefits beyond weight loss. They can improve or even resolve conditions associated with obesity like heart disease, high blood pressure, severe sleep apnea, type 2 diabetes, and more. While these procedures can provide substantial health benefits, they also come with their own risks and side effects that need to be carefully considered before deciding on this path for weight loss.

Coresource Insurance Coverage

Coresource is a trusted name in the health insurance industry, providing a range of coverage plans designed to meet the diverse needs of its policyholders. When it comes to bariatric surgery, the coverage provided by Coresource can vary greatly depending on factors such as the specific plan details, the state of residence, and the individual’s particular medical condition. It’s important to note that while some Coresource plans do cover bariatric surgery, not all do. Therefore, it’s crucial for those considering this procedure to check their policy documents or consult with Coresource directly to understand their coverage.

Navigating through health insurance policies can be complex, especially when it comes to specialized procedures like bariatric surgery. Generally, if a policy does cover bariatric surgery, it may require that certain criteria be met before approval for the procedure is granted. These requirements often include proof of medical necessity, previous failed attempts at weight loss through traditional methods, and participation in a medical weight management program. While these are common requirements across many insurance providers, the specifics can differ from one provider to another and even from one policy to another within the same provider.

As part of their commitment to policyholder health and wellbeing, Coresource has customer service representatives available to answer questions about coverage details. They can provide information on what types of bariatric surgeries are covered under a specific plan and what criteria need to be met for approval. It’s also worth noting that Coresource may provide coverage for necessary pre-operative tests and postoperative care related to bariatric surgery. Thus, it’s always beneficial for those considering this life-altering procedure to reach out directly to Coresource or a knowledgeable healthcare professional well-versed in health insurance matters. This can help ensure they fully understand their coverage options and any potential out-of-pocket expenses they may incur.

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