What Insurance Companies Cover Weight Loss Surgery?

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Have you been considering weight loss surgery, but aren’t sure if your insurance will cover it? You’re not alone. Many people are in the same boat, and the process of finding out can be confusing. In this blog post, we’ll break down what insurance companies cover when it comes to weight loss surgery. We’ll also give you some tips on how to navigate the insurance landscape and get the coverage you need. 

What is Weight Loss Surgery?

Weight loss surgery is a type of surgery that helps people lose weight. There are many different types of weight loss surgery, but the most common type is gastric bypass surgery. Gastric bypass surgery makes your stomach smaller and allows food to bypass part of your small intestine. This type of surgery can help you lose a lot of weight in a short period of time, but it also has some risks.

What Insurance Companies Cover Weight Loss Surgery?

There are a number of insurance companies that cover weight loss surgery, and the coverage varies from company to company. Some insurers will only cover the surgery if it is deemed medically necessary, while others will cover it if the patient meets certain criteria, such as having a body mass index (BMI) of 35 or higher.

It is important to check with your individual insurance carrier to see what their coverage for weight loss surgery is. You can usually find this information on the insurer’s website or by calling their customer service number. Keep in mind that even if your insurance company does cover weight loss surgery, you may still be responsible for paying some out-of-pocket costs, such as a deductible or coinsurance.

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What are the Requirements for Coverage?

There are a few requirements that insurance companies typically require before they will cover weight loss surgery. First, the patient must have a body mass index (BMI) of 40 or more, or a BMI of 35 or more with one or more obesity-related health conditions. Second, the patient must have attempted to lose weight through diet and exercise for at least six months without success. Third, the patient must be able to demonstrate that they are committed to making long-term lifestyle changes, including following a healthy diet and exercising regularly.

If you meet these requirements, your insurance company may cover some or all of the costs of weight loss surgery. However, it’s important to note that each insurance company is different, so it’s always best to check with your provider to see what they will and won’t cover.

How Much Does Weight Loss Surgery Cost?

Weight loss surgery is not cheap. The typical cost of gastric bypass surgery is between $15,000 and $25,000. The cost of laparoscopic gastric banding surgery is a little less, at around $13,000 to $22,000.

Of course, these are just averages. The cost of weight loss surgery will vary depending on the type of procedure you have, your surgeon’s fees, the hospital where you have the surgery, and your insurance coverage.

If you don’t have insurance or if your insurance doesn’t cover weight loss surgery, there are other options available to help you pay for the procedure. Many surgeons offer financing plans, and there are also a number of charities that provide financial assistance for people who need weight loss surgery but can’t afford it.

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Alternatives to Weight Loss Surgery

There are many alternatives to weight loss surgery that insurance companies may cover. These include lifestyle changes, medication, and other medical procedures.

Lifestyle changes: Making healthier choices can help you lose weight and keep it off. This includes eating a balanced diet, getting regular exercise, and reducing stress.

Medication: Some medications can help with weight loss by suppressing your appetite or increasing your metabolism. However, these drugs must be taken under a doctor’s supervision and may have side effects.

Other medical procedures: If lifestyle changes and medication don’t work, there are other options such as gastric bypass surgery or laparoscopic sleeve gastrectomy. These are more invasive procedures with greater risks, but they may be covered by insurance if you meet certain criteria.

Conclusion

If you are considering weight loss surgery, it is important to check with your insurance company to see if they will cover the procedure. While some insurers will cover part or all of the cost of surgery, others will not. This article has provided an overview of what insurance companies cover weight loss surgery and how you can find out if your insurer will help pay for the procedure. If you have any questions, be sure to contact your insurer directly to get more specific information.