Bariatric Surgery

Duke has introduced a new provision for bariatric surgery as part of a pilot incentive program from Jan., 1, 2015, to July 1, 2016.

Pilot Incentive Program:

  • Patients can receive a $500 incentive in the form of a health reimbursement debit card if they complete and document an additional 6 months of Pathways to Change or Weight Watchers after the procedure.
  • The 6 months of Pathways to Change or Weight Watchers* must be completed during the dates of the pilot program (Jan. 1, 2015 to July 1, 2016).
  • The health reimbursement debit card can be used for any eligible health care expense for the current or subsequent calendar years.
    *Weight Watchers participants must attend meetings. The online program is not applicable to this pilot.
Note: participants who have completed weight-loss surgery while covered on a Duke health plan prior to Jan. 1, 2015, are eligible for the $500 incentive if they complete and document an additional 6 months of Pathways to Change or Weight Watchers during the dates of the pilot program (Jan. 1, 2015 to July 1, 2016).

Eligibility

Bariatric surgery will be available for patients who meet all of the following criteria:
  • Employee or covered spouse must be covered under Duke Select, Blue Care or Duke Options
  • Employee must be employed at Duke in a benefit-eligible category for at least 5 continuous years as reflected by your current continuous service date
  • Patient must have a Body Mass Index (BMI) of 40 or more, or between 35-39 BMI with significant co-morbid condition
  • Patient must meet physician's medical/psychological criteria
  • Patient must have fully participated in:
  • Pathways to Change through LIVE FOR LIFE for at least 3 months prior to the procedure, or
  • Weekly documentation of attendance at Weight Watchers*, evidence of two visits to a nutritionist, and an exercise log showing physical activity at least three times/week for at least 3 months prior to the procedure.
    *Weight Watchers participants must attend meetings. The online program is not applicable to this pilot.
The surgery will only be available at a Duke facility. There will be a co-pay of $2,500. Ask your physician for more information if you believe you are eligible for bariatric surgery.