Health benefits folder.

Humana – HCA Employees – Criteria for Weight Loss Surgery

In Am I Covered by OC Staff

To qualify for coverage of weight loss surgery, your policy must include coverage. Not all policies include coverage. To find out if you policy includes coverage, please talk directly to Humana.

Humana for HCA employees covers weight loss surgery. In order for Humana to cover your surgery, you will still have to meet the qualifications and your policy must not exclude weight loss surgery coverage.

Humana for HCA Employees Pre-Approval Requirements

The criteria below must be met in order to have Humana for HCA employees pay for your weight loss surgery.

  1. A Body Mass Index of 40 or greater, or…
  2. A Body Mass Index of 35 to 39 with at least one clinically significant co-morbidity.
  3. A letter of medical necessity from a physician – typically your primary care provider.
  4. Complete a physician supervised diet for 6 months within the last two years.
  5. Successfully complete a psychological evaluation.
  6. Complete a nutritional evaluation and meet with a dietitian or nutritionist.

Which Procedures are Covered by Humana for HCA Employees?

  • Gastric bypass surgery
  • Lap gastric bands
  • Gastric sleeve surgery
  • Duodenal switch surgery

Are Lap Band Fills Covered?

Yes, lap band fills are covered if your original lap band surgery was covered by insurance.

Which Procedures are Not Covered?

Any procedure that is considered experimental. Generally, this means any procedure other than the ones listed as covered.

Humana’s Bariatric Management Program

Humana offers an excellent service specific for members interested in weight loss surgery. The program is available to answer any questions you may have before, during or after your surgery.

I strongly urge you to use this free service and applaud Humana for offering it and essentially streamlining the process of getting approved.

Humana’s for HCA Employees Contact Information

Reach out to Humana’s Bariatric Management Program via the email or phone number below.

Phone: 1-866-486-5295
E-mail: [email protected]
Fax: 1-502-508-0049


Share this Post