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The minimum qualification for consideration as a candidate for the procedure through your insurance is a Body Mass Index of 40 or greater (which for men equates to roughly 100 pounds above ideal body weight or approximately 80 pounds above ideal body weight for women). If covered on your insurance plan, typically surgery will be considered for someone with a BMI of 35 or higher if the patient is suffering from serious negative health conditions, such as diabetes, high blood pressure, or sleep apnea. In many cases, insurance companies require proof that attempts at non-surgical dietary weight loss have been ineffective before surgery will be approved. If your BMI is between 30 – 34, you may be a candidate for gastric banding; however, insurance will not cover surgery for those with a BMI within this range. Please see our “can I afford NOT to have surgery?” page for financing options.
More important, however, is the commitment on the part of the patient to the required long-term follow-up care. Patients are required to demonstrate serious motivation and a clear understanding of the extensive dietary, exercise, and medical guidelines that must be followed for the remainder of their lives after having weight loss surgery.