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If you’ve heard of SurgeryPlus, used its portal in the past, or were told bariatric surgery wasn’t covered under your plan, you may be working with outdated information. That’s because SurgeryPlus is now Lantern.
With Lantern, your North Carolina State Health Plan benefits didn’t disappear, and in many cases, they grew. We want to make sure this update reaches as many people as possible – for eligible patients, this change could mean access to bariatric surgery at no cost. For individuals considering weight loss surgery, that knowledge alone can be life-changing.
If you or someone you love is covered under the North Carolina State Health Plan, has old SurgeryPlus information, and is thinking about bariatric surgery, this blog is for you.
A New Benefit: Bariatric Surgery
Bariatric surgery is a medically proven intervention that can improve, or even reverse, obesity-related conditions like type 2 diabetes, high blood pressure, and sleep apnea. Patients often experience improved mobility, reduced pain, better sleep, and renewed energy that allows them to re-engage with daily life.
But surgery is not a one-day fix, and long-term success depends on:
- Regular follow-up appointments
- Ongoing dietary modifications
- Consistent physical activity
- Behavioral health therapy and strong support networks
Programs like Lantern are part of that support network, helping patients navigate the financial aspect of bariatric healthcare. And with Bariatric Specialists of the Carolinas, patients aren’t left to figure things out alone. Care Advocates and nurse navigators are with you to coordinate each step, from initial consultation and surgical preparation to recovery and long-term maintenance, so patients are set up for sustainable results.
What “No-Cost” Really Means
For qualifying members of the North Carolina State Health Plan, bariatric surgery comes with no out-of-pocket cost when patients choose a provider within Lantern’s Network of Excellence.
That means:
- No deductibles for surgery
- No surprise surgical bills
- Access to rigorously vetted bariatric surgeons
- Coordinated care from experienced teams
At Bariatric Specialists of the Carolinas, we’re proud to participate in this program and expand access to high-quality surgical care for North Carolinians across the state. Patients still go through a structured medical process, including eligibility verification, evaluations, and preparation, but financial barriers are significantly reduced.
If you’ve struggled with weight loss and assumed surgery was financially out of reach, this updated benefit can change what’s possible.
Surgical Requirements
Over 740,000 public employees, educators, retirees, former lawmakers, university and community college personnel, and their families are covered by the North Carolina State Health Plan. Patients must meet general bariatric candidacy guidelines and additional program-specific criteria to be considered for bariatric surgery.
Body Mass Index (BMI) Guidelines
Adults generally qualify with:
- A BMI of 35 or higher (or 32.5+ for individuals of Asian descent), or
- A BMI of 30 or higher (or 27.5+ for Asian ancestry) when accompanied by at least one significant obesity-related medical condition
Adolescents who have completed bone growth may also qualify with a BMI of 40 or higher, following additional evaluation.
Qualifying medical conditions include:
- Type 2 diabetes
- High blood pressure that is difficult to control with medication
- Obstructive sleep apnea
- Coronary heart disease
- Nonalcoholic steatohepatitis (NASH)
Covered Bariatric Procedures
The North Carolina State Health Plan currently includes coverage for several established bariatric procedures:
- Roux-en-Y gastric bypass (RYGB)
- Sleeve gastrectomy
- Biliopancreatic diversion with duodenal switch (DS)
- Sleeve gastronomy with single anastomosis duodenal-ileal bypass (SADI)
In some instances, additional procedures may be approved when medically necessary to address complications or revise prior bariatric surgeries:
- Removal or replacement of a gastric band due to complications
- Conversion of sleeve gastrectomy to RYGB for treatment of severe GERD
- Surgery to correct obstruction, stricture, erosion, or band slippage
- Repeat bariatric surgery if adequate weight loss was not achieved after two years, provided patients adhered to the recommended diet and activity guidelines
Other medically indicated procedures, such as gallbladder removal during bariatric surgery when gallbladder disease is present, may also be performed.
Lighting the Way
We encourage you to ask questions, confirm your benefits, and explore your options. At Bariatric Specialists of the Carolinas, we’re here to help you understand whether bariatric surgery is right for you and how to navigate the process through Lantern.
Sometimes, the first step toward change isn’t deciding on surgery – it’s realizing that the door is already open.
