CG-SURG-83
ANTHEM-cg-surg-83
Bariatric surgery is covered for adults ages 18 and older with a BMI of 40 or greater, or a BMI of 35 or greater with related obesity comorbidities, provided they have participated in a medically supervised weight loss program for at least 6 months and completed required medical and mental health evaluations. Coverage includes surgeries such as gastric bypass and sleeve gastrectomy, but excludes individuals with a recent history of substance abuse and those without documented commitment to conservative treatment. Prior authorization and clinical documentation of obesity-related conditions are necessary for approval.
"Bariatric surgery is covered for adults with a BMI of 40 or greater."
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