Coverage Criteria Policies

These services may or might not be covered by all HealthPartners plans. Please see your plan documents on your own coverage information. If there is a difference between this general information as well as your plan documents, your plan documents will be utilized to determine your coverage. Prior authorization is not required for weight loss management.

Please see related content at the befitting connect to the Dietitian Consultation policy. Authorization is required for Weight Loss Surgery Prior. Please see related content at the right for link to the Weight Loss Surgery policy. A member’s medical coverage is bound to certain physician-supervised medical weight reduction or medical management treatments which have been clinically proven. 1. Physician-directed dietary appointment services are covered when the medical criteria that are outlined in the Dietitian Consultation Policy have been fulfilled. Please see related content for at the right for link to plan.

2. The medical criteria detailed in the Weight Loss Surgery Policy have been satisfied. Please see related content for at the befitting link to plan. In addition to people interventions that are covered under your policy, there are other interventions or lifestyle activities that you may wish to go after or may be suggested by your physician or health care professional that are not covered.

1. Health and fitness center memberships, exercise programs, use of workout equipment or purchase of exercise equipment. 2. Physical performance tests and measurement, including, but not limited by: pulmonary stress tests to determine exercise capacity as a regular component of a fitness program. 3. Lifestyle-behavioral resources or equipment (i.e. biofeedback, support groups). 4. Support programs such as Weight Watchers, Jenny Craig, Diet Center, Zone Diet or other similar programs.

5. Nutritional supplements and foods, including but not limited to vitamins, amino acid solution supplements, Optifast, Medifast, prepackaged foods such as NutriSystem or phytotherapy. 7. Day treatment programs for weight reduction Inpatient or. Weight loss management is a lifelong process of balanced eating, exercise and lifestyle change. These strategies have proven successful in attaining or maintaining a healthy body weight, improved health and decreased risk for disease. Weight loss management can include dietitian appointment also. In certain circumstances, weight loss surgery may be considered.

  • Medicism (6)
  • 2 hours of bicycling at a swiftness of 10-12 km / h
  • One 12 FL OZ (355 mL) can of Coca-Cola has 140 calories and 0 grams of fats
  • Blood in the urine
  • 60 x 9 = 540

Even after surgery, lifelong medical security and a weight maintenance program of balanced eating, physical lifestyle and activity change are essential. Body Mass Index (BMI) is way of measuring body fat based on height and weight that pertains to both adult men and women. Please see related content at the befitting a web link to estimate your BMI.

In order to see whether weight loss management is essential, doctors might use the following measures to see whether a person is obese or obese. These measures follow the National Heart, Lung and Blood Institute’s (NHLBI) clinical guidelines for identifying and treating overweight and obesity in adults. Individual’s body mass index (BMI) is 25-29.9 (Class I), 30-40 (Class II) or higher than 40 (Class III).

Women with a BMI of 25 to 34.9 and a waist greater than 35 inches. Men with a BMI of 25-34.9 and a waistline higher than 40 inches. Co-existing health issues including high blood pressure, raised chlesterol, diabetes and/or obstructive sleep apnea can be found. Weight loss management programs that add a low-fat and low-calorie diet, regular physical exercise, as well as education and support to make changes in lifestyle are typically the first option for overweight and obese adults. Although these planned programs are essential to preserving good health, payment for these planned programs is not reimbursed under your policy. This information is for most, however, not all, HealthPartners plans.