Bariatric Surgery Coverage for Medica Members
If you are considering bariatric (weight-loss) surgery, please call Customer Service at the number on your ID card and they will help you every step of the way.
When you call:
1. Customer Service will check if your health plan provides coverage for bariatric surgery.
2. If you do have coverage for bariatric surgery;
Customer Service will help you choose a bariatric surgeon and hospital that participate in our Centers of Excellence program AND in your health plan’s network.
Not all Centers of Excellence health care providers participate in every health plan network, so this is important.
What’s the Centers of Excellence program? The goal of the Centers of Excellence program is to ensure that members receive safe, high-quality care. Bariatric surgeons and hospitals approved by Medica’s Centers of Excellence have undergone thorough screening and have met stringent quality standards.
3. Customer Service will determine if your health plan requires a referral from your primary care provider in order to receive bariatric surgery.
If you have a Medica Elect or Medica Essential plan, most likely you will need a referral. Other plans do not require a referral.
4. Customer Service will help you get prior approval for the surgery.
This approval (also called “prior authorization”) for bariatric surgery is required for all Medica plans.
Return to previous page.