Obesity (bariatric) surgery is covered only in very specific clinical circumstances, and only for those enrollees who participate in UMP’s case management program. UMP will cover the surgery only if the patient meets all case management requirements, including those for before and after surgery. The final decision as to whether the surgery will be covered is made by a UMP Medical Director after all presurgical requirements are met. Approval will not be granted to patients who had previous bariatric surgery within the last 10 years or any prior bariatric surgery covered by a PEBB health plan. The enrollee must use providers and facilities designated by UMP.

UMP covers only certain types of bariatric surgery procedures. Other procedures will not be considered for coverage.

TIP:  Enrollees who want to be evaluated for the obesity presurgical program must complete the online questionnaire. Please note that completing the questionnaire is requesting coverage for obesity surgery, and you can request coverage only once per calendar year.