City Of LaCrosse, ATU & SEIU Weight Loss Surgery Coverage

It appears that the City Of LaCrosse, ATU, SEIU and their retirees’ medical plan has coverage for weight loss surgery. Plan information can be found here. Page 91 discusses bariatric surgery coverage requirements.

Having coverage does not mean you will get approved or that you qualify.

Requirements to Qualify For Surgery

The City of LaCrosse, ATU, SEIU and their retirees Medical Plan has the following requirements to be eligible for weight loss surgery:

1. Two years of physician supervised weight loss.
   1. The physician supervising your weight loss cannot be a bariatric surgeon.
   2. The two-year requirement is longer than most plans, so start your physician supervised weight loss program today.
2. You must show evidence of complications as a result of obesity. These are called comorbidities.
3. Body Mass Index of 40 or more for longer than 2 years or
4. Body Mass Index of 35 to 40 with at least to co-morbid conditions for longer than 2 years.
5. A recommendation from your primary care physician is strongly recommended.

Weight Loss Procedures Covered

The standard weight loss procedures are covered by the City of LaCrosse’s Medical Plan. These include:

1. Gastric Bypass
2. Gastric Sleeve
3. Lap Band

 Duodenal Switch surgery may be covered. However, we were not able to verify this.

Contact

More information regarding your benefits can be found here on page 91, under Morbid Obesity.