When diets and exercise aren't helping you shed excessive weight, bariatric surgery can give you a jumpstart on your weight-loss program, allowing you to envision a healthier lifestyle. The Centers for Disease Control notes: "Obesity is a costly condition that can reduce quality of life and increases the risk for many serious chronic diseases and premature death." Recognizing this, Medicare now allows some individuals in specific circumstances to undergo bariatric surgery under Medicare's auspices. Medicare-approved clinics throughout Washington open this possibility to Medicare clients.
Approved Weight Loss Clinics in Washington
A Medicare patient may only go to a Medicare-approved "Center of Excellence" for weight-loss surgery. Centers of Excellence in Washington state include Overlake Hospital Medical Center in Bellevue, St. Francis Hospital-Franciscan Health System in Federal Way, Virginia Mason Medical Center in Seattle, Evergreen Hospital in Kirkland, Mason General Hospital in Olympia, Sacred Heart Medical Center in Spokane and Southwest Washington Medical Center in Vancouver.
Medicare Guidelines for Surgery Qualification
To qualify for coverage under Medicare guidelines you must have a body mass index (BMI) of 35 or greater, suffer from at least one weight-related condition (heart disease, diabetes or sleep apnea), provide documented evidence of past attempts to lose weight in supervised weight-loss programs (exercise programs, diet program, counseling or drug therapy), undergo a psychological evaluation and have a physician rule out other medical treatments.
Criteria for Certification as a Center for Excellence
Medicare relies on the American Society for Metabolic and Bariatric Surgery's certification of "Centers of Excellence" when approving hospitals and other institutions where Medicare-approved surgery can take place. To qualify as a Center for Excellence, the institution or hospital must perform at least 125 bariatric surgeries per year. The surgeon must have performed 125 or more bariatric surgeries in the past and must perform 50 or more per year. The institution must report on long-term patient outcomes and provide on-site inspection to verify the data, as well as have a multi-disciplinary bariatric team which includes surgeons, medical consultants, nurses nutritionists, psychologists and exercise physiologists.
The Need
The obesity rate in America continues to rise. A 2009 report released by the Trust for America's Health reports that "adult obesity rates increased in 23 states and did not decrease in a single state in the past year." Obesity causes heightened risks for strokes, heart diseases, certain cancers, diabetes, gynecological and gastroenterological disorders and other disabilities and medical conditions. For some people, weight-loss programs of diet and exercise don't adequately address their excess weight and surgery offers their only solution.
About Bariatric Surgery
Bariatric surgery reduces the size of the individual's stomach, thereby reducing the amount of food that they can eat. Bariatric surgery involves either implanting a medical device in the stomach (gastric banding), removing a portion of the stomach (biliopancreatic diversion or sleeve gastrectomy) or resecting and re-routing the small intestines to a small stomach pouch. Risks associated with bariatric surgery include death, bleeding, ulcers, bowel obstructions, pulmonary embolism, infections, gallstones and other complications.
References
- Trust for America's Health: F as in Fat 2009
- Centers for Medicare and Medicaid Services: Medicare National Coverage Determinations
- Insure.com: How to Get your Health Insurer to Pay for Your Weight-Loss Surgery
- Centers for Medicare and Medicaid Services: Bariatric Surgery
- Washington State Insurance Commissioner: Medicare
- Medicare.com: Bariatric Weight Loss Surgery
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