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Hi Bianca,

There are some Florida Blue policies which do cover surgery (including the sleeve) and many which do not. So the big question is what certificate do you have? You can look it up on their portal as a Member but at least I can give you the link to their Medical Policy:

Subject: Bariatric Surgery - Effective 12-15-2018

Here is their general criteria:

Selection criteria (Adults)

*Severely obese with a BMI ≥ 40 kg/m2, OR

*Severely obese with a BMI ≥ 35 kg/m2, with at least one comorbidity refractory to medical management (e.g., type 2 diabetes, hypertension, coronary artery disease, obstructive sleep apnea, GERD, osteoarthritis, pseudotumor cerebri), AND

 Does not have a medically treatable cause for obesity (e.g., thyroid or other endocrine disorder), AND  Has made multiple attempts at non-surgical weight loss (e.g., diet, exercise, medications), AND  Has received psychological or psychiatric evaluation with counseling as needed, prior to surgical intervention.

Good luck! Hope this helps. Happy New Year!

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Hi Bianca,
There are some Florida Blue policies which do cover surgery (including the sleeve) and many which do not. So the big question is what certificate do you have? You can look it up on their portal as a Member but at least I can give you the link to their Medical Policy:
Subject: Bariatric Surgery - Effective 12-15-2018
Here is their general criteria:
Selection criteria (Adults)
*Severely obese with a BMI ≥ 40 kg/m2, OR
*Severely obese with a BMI ≥ 35 kg/m2, with at least one comorbidity refractory to medical management (e.g., type 2 diabetes, hypertension, coronary artery disease, obstructive sleep apnea, GERD, osteoarthritis, pseudotumor cerebri), AND
 Does not have a medically treatable cause for obesity (e.g., thyroid or other endocrine disorder), AND  Has made multiple attempts at non-surgical weight loss (e.g., diet, exercise, medications), AND  Has received psychological or psychiatric evaluation with counseling as needed, prior to surgical intervention.
Good luck! Hope this helps. Happy New Year!
Thank You Happy New Year's To Also[emoji7][emoji8]

Bianca

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