How to Request Coverage
The first step in requesting coverage for either obesity surgery is to fill out the questionnaire. The questionnaire asks about your current weight, medical history, and medications you currently take.
UMP case management staff will then review your answers. You will be notified of the outcome within 14 days.
Note: If you are interested in laparoscopic adjustable banding surgery, do not complete the online questionnaire until January 1, 2009. Unless you are between ages 18 to 21 years, this surgery is not covered until then.
Letter of Acceptance
If your responses to the questionnaire meet the criteria for further evaluation, you will receive a letter of acceptance to the presurgical program. The letter will provide you with the phone number of a UMP case manager to call so you can set up an appointment to go over your medical history and discuss the requirements of the program. If it is determined that you meet the requirements, you are required to submit documentation from your medical providers and begin to lose weight. Once the case manager has received all of the required information and verified that you have met all of the program requirements, your case will be sent to a UMP medical director for review.
Center of Excellence Referral
If the UMP medical director determines you have met all requirements, you will be referred to a Center of Excellence for further evaluation. These evaluations include a visit with a surgeon and a mental health specialist; as well as possible visits to a dietitian, nutritionist, and other specialists to ensure you have the best outcome possible. All care will be directed by your UMP case manager and a UMP medical director. The decision regarding which obesity surgery you have will be made by you and the surgeon at the designated Center of Excellence.
Medical Director's Final Review
Once you have been evaluated at the Center of Excellence and it is determined that you are a candidate for surgery, your file will be reviewed again by a UMP medical director, who will make the final determination whether obesity surgery will be covered.
You may apply to the program no more than once per calendar year.
