If you’ve failed to lose weight by dieting and exercising, perhaps it’s time to consider an alternative treatment that promises fast and noticeable results. Gastric bypass surgery, which helped patients lose an average of almost 65 pounds in 2015, is one of four popular procedures that help those struggling with weight loss to overcome it. In fact, gastric bypass has the highest success and lowest complication rates of the four weight loss surgeries.

With that said, here are the physical and Medicaid requirements to qualify you for gastric bypass surgery.

The Physical Requirements for Gastric Bypass Surgery

Have a BMI equal to/greater than 40 or weigh more than 100 pounds overweightTo qualify for gastric bypass surgery, you must meet one of the following three physical requirements.

  • Have a BMI equal to/greater than 40 or weigh more than 100 pounds overweight
  • Have a BMI equal to/greater than 35 and at least two conditions* related to obesity
  • Inability to successfully lose weight and sustain it with standard methods of weight loss

*  Common conditions include type II diabetes, hypertension, heart disease, and other disorders involving the respiratory system and the gastrointestinal tract

It’s important that you first try traditional methods of weight loss before resorting to gastric bypass surgery. If all else has failed, though, the next step is to speak with your physician to determine your eligibility and a plan of action. Once you’ve qualified for gastric bypass surgery physically, you’ll need to check if your insurance covers it.

The Medicaid Requirements for Gastric Bypass Surgery

Medicaid’s requirements for gastric bypass surgery coverage are different than those of other insurance plans. In addition to being free from any medical-related issues that would prevent you from having surgery, you need to adhere to these two requirements in order for Medicaid to cover and pay for your weight loss procedure.

First, you must meet ALL of the following criteria:
Gastric Bypass Requirements

  • Older than 13 years old if you’re a female; older than 15 if you’re a male.
  • BMI must exceed 35 with at least one chronic condition*.
  • If younger than 21, your BMI must exceed 40 with at least one chronic condition*.
  • Possess a printed letter from your physician recommending the surgery.
  • Pass a mental health exam proving you can adopt the necessary changes in lifestyle to lose weight.
  • Documentation proving you’ve tried traditional methods of treatment and were unsuccessful.
  • Complete a medically supervised program spanning six months for weight loss.

*  Common conditions include type II diabetes, high blood pressure, sleep apnea and high cholesterol

Second, you must have the gastric bypass surgery done through the Center for Excellence. This ensures the surgeon and the office perform to a high standard of treatment and that you’ll receive the best results possible.

For more information about how gastric surgery can improve your mental health, mobility and quality of life, contact your physician for a consultation. He or will study your medical history and determine whether you’re eligible for it.