Does Alabama Medicaid Cover The Cost Of Gastric Bypass?

Question

Asked by Kathi May

Does Alabama Medicaid Cover The Cost Of Gastric Bypass?

Answer

Hi Kathi,

Here is a listing (pdf) of what obesity-related services are covered by different state's medicaid departments. It appears that bariatric surgery is covered under Alabama Medicaid (one surgery/patient) if supporting evidence is documented. Here is the specific information:

Covered Procedures:
Gastric Bypass and Lap Band surgeries. Agency covers one surgery/patient.
Prior Authorization: Beneficiary must have a

  1. BMI consistent with morbid obesity diagnosis;
  2. Presence of obesity-related medical complications;
  3. Planned adjunctive therapy before and after surgery;
  4. Physician-patient risk benefit counseling;
  5. Minimum 6 months physician-supervised weight loss efforts BMI consistent with morbid obesity diagnosis.8

If you go to the pdf, you will find links to related documents at the bottom of each page. You may want to check those out.