What weight loss surgery is covered by insurance?

Bariatric surgery insurance coverage varies by policy. If your policy covers weight-loss surgery and you meet the qualification requirements, most plans will pay for you to undergo gastric sleeve, gastric bypass, lap band, or duodenal change surgery. Insurance companies that cover bariatric surgery have different requirements. Some may require medical records that document that you have medical problems caused by your weight or records of your participation in weight loss programs supervised by a doctor.

In fact, many insurers require at least six months of participation in a supervised weight loss program within two years of the date of the proposed surgery. You may need to provide documentation of attempts to lose weight, including diet and exercise regimens, to get insurance approval. How you choose to pay for your procedure: If insurance covers you, you will only be responsible for the copays, deductibles and coinsurance required by your specific plan. Some insurance companies have a mandatory three-month weight control protocol that you must complete before surgery.

However, it's important that you check with our office to make sure your health policy covers your weight-loss surgery procedure. Fortunately, many insurance companies recognize the serious health threats of obesity and cover weight-loss surgery as long as it meets qualification requirements. If you have Medicare, Medi-Cal, or Medicaid coverage, be sure to find out what specific coverage is available to you by contacting your health plan. Medicare covers some bariatric surgical procedures if you meet certain conditions related to morbid obesity.

Remember that it took you a long time to gain weight and you've probably been trying to lose weight for most of your life. Before you appeal, make sure you understand your policy in its entirety and that it doesn't specifically exclude the weight-loss surgery you want. Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare, and United Health Care often cover weight-loss procedures. But did you know that losing weight can help? Read on to learn how GERD is affected by weight loss.

Without health insurance, bariatric surgery is economically inaccessible to many people, a sad fact because weight-loss surgery is often a medical necessity. Enter your information in the tool to get an idea of how much weight you'll lose after each procedure. This may include completing a physician-supervised weight loss plan developed by the insurance provider or making other weight-loss efforts as recommended by a doctor. Finally, most insurance companies will require that your patient stop smoking and not show any evidence of substance abuse or have a recent history (within the past 5 years) of substance abuse before covering bariatric surgery.

Gerald Clabaugh
Gerald Clabaugh

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