Bariatric Surgery

Benefits eligible University of Miami employees, covered under the UM/Aetna plan, are eligible for coverage of bariatric surgery. There is no coverage for spouses and/or dependent children.

 

Employee Eligibility

The patient is a University of Miami employee covered by the University of Miami/Aetna health plan.

Provider Requirement

Surgical procedure must be performed at University of Miami's UHealth Tower by UHealth Bariatric Specialists.

Clinical Requirement

The employee will only be covered if they meet Aetna's clinical criteria for obesity surgery.

Aetna Institute of Quality ("IOQ")

UHealth Tower is a member of the Aetna Institutes of Quality ("IOQ") for Bariatric Surgery. Facilities in this notable network must meet the following criteria:

  • Have significant experience in bariatric surgery, including a minimum of 125 procedures in the most recent calendar year
  • Evidence-based and recognized standards for clinical outcomes, processes of care and patient safety
  • Provide on-going follow-up programs and support for their bariatric surgery patients
  • Adhere to Aetna's standards for member access to the facility and Aetna participating providers
  • Demonstrate efficiency in providing care based on overall cost of care, readmission rates and comprehensiveness of program

Please click here for Summary of Criteria for Facility Consideration.

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