Horizon BCBS NJ Updates Bariatric Surgery Criteria to Include Patients with BMI Over 30 and Type 2 Diabetes

Horizon Blue Cross Blue Shield of New Jersey recently updated their bariatric coverage policy to include members with a BMI > 30 with a comorbidity of Type 2 Diabetes.

For members with diabetes and with a BMI > 30 kg/m2, the following bariatric surgery procedures are considered medically necessary in adults who have failed weight loss by conservative measures:

• Biliopancreatic Diversion
• Laparoscopic Adjustable Gastric Banding
• Roux-en-Y Gastric Bypass
• Sleeve Gastrectomy

Bariatric surgery, also known as weight loss surgery, has been shown to be effective in resolving diabetes in many cases. Obesity is a significant risk factor for developing type 2 diabetes, and losing weight through bariatric surgery can help to reverse or significantly improve the condition. The surgery can help to regulate blood sugar levels, reduce insulin resistance, and decrease inflammation in the body. Studies have shown that up to 90% of patients who undergo bariatric surgery see improvement in their diabetes, and many experience complete remission of the disease. However, it is important to note that bariatric surgery should be considered as part of a comprehensive treatment plan that includes lifestyle changes and ongoing medical care.

For more information, please call 973-410-9700 or contact us online.