Will Insurance Cover Weight Loss Surgery?

August 25, 2023

Weight loss surgery can be a life-changing experience for those suffering from morbid obesity or other weight-related conditions. Unfortunately, many people may not pursue it because of the significant costs involved even though it can significantly improve their long-term health outlook. Like most surgeries, bariatric surgery can be prohibitively costly for many patients. However, there’s a possibility your insurance coverage may help defray at least some of the costs to help make it more financially feasible for you. If you’re considering sleeve gastrectomy, gastric bypass, laparoscopic banding or another surgery as part of your weight loss journey, read on to learn more about how your insurance may be able to provide it.

UNDERSTANDING THE COSTS

Considering the complexity of the most commonly performed weight loss surgeries, it should come as no surprise that there are some serious costs involved. It is important to note that there are numerous factors that influence the final price tag of a particular procedure, such as the length of the hospital stay, labs, tests and any prescriptions that may be needed. If you’re already working with a weight loss specialist, it’s a good idea to ask about the potential costs when discussing your options so you know what to expect. We at Center for Weight Loss Surgery will verify your insurance benefits and explain these to you before you schedule your consultation, so you are prepared financially for the surgery.

HOW INSURANCE MAY BE ABLE TO HELP YOU

Will insurance cover your weight loss surgery? In the past, the answer most likely would have been “no.” However, in recent years a growing number of insurance providers have changed their approach to these procedures and many policies now include coverage for many of the most commonly performed surgeries. Although gastric sleeves and lap bands used to be considered experimental, today they have been proven to work for many patients and as such have been added to the list of approved surgeries with many insurers.

While your provider may cover these surgeries in a broader sense, for the individual it all depends on the specific policy and what is included. Certain types of policies exclude weight loss surgery, so it’s important to contact your insurer to inquire about your level of coverage and what may be included.

If your insurance plan has benefits for weight loss surgery, then you may be required to meet their criteria prior to having the surgery approved. Most plans will approve the surgery if your BMI is above 40 or if the BMI is between 35 and 39.9 then there should be an underlying obesity related health condition like diabetes, hypertension, sleep apnea, cardiovascular disease, etc.  You may also need to complete a pre-surgery weight loss program or provide documented proof of your past efforts to lose weight.

TALK TO THE EXPERTS TODAY

If you’re already working with a weight loss surgeon, discussing the financial aspects of your procedure is an essential part of the process. This will ensure you fully understand what to expect and avoid any unnecessary hardships after the fact.

If you’re still looking for expert treatment for your journey, the Center for Weight Loss Surgery can help. We offer a wide range of options when it comes to bariatric procedures and will work with you to find the one that’s right for your needs as well as your financial resources. To learn more about how we can help you, reach out and talk to us today.

Center for Weight Loss Surgery is In Network with the following Insurance Companies:

  • Aetna
  • Cigna
  • United Healthcare (UHC)
  • UMR
  • Regence
  • Premera Blue Cross
  • Blue Cross Blue Shield (BCBS)
  • Kaiser Permanente
  • First Choice Health

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