Bariatric surgery, also known as weight-loss surgery, is an effective solution for those struggling with obesity. However, the cost of bariatric surgery can be prohibitive, with prices ranging from $15,000 to $28,000. This leaves many wondering if their insurance plan will cover the cost of this life-changing procedure. In this article, we will answer the question: Does insurance cover bariatric surgery?
What is Bariatric Surgery?
Bariatric surgery is a surgical procedure that helps individuals who have obesity lose weight. The procedure is performed on the stomach or intestines to alter the digestive process, leading to a decrease in the amount of food an individual can eat and the amount of calories they can absorb.
Bariatric surgery is not a quick fix for obesity but rather a tool that can help individuals make the necessary lifestyle and dietary changes to manage their weight long-term.
Types of Bariatric Surgery
There are several types of bariatric surgery, including:
Type of Surgery |
Description |
Gastric Sleeve |
The surgeon removes a portion of the stomach to create a smaller, banana-shaped pouch. |
Gastric Bypass |
The surgeon creates a small pouch at the top of the stomach and reroutes the small intestine to the pouch, bypassing a portion of the stomach and small intestine. |
Gastric Banding |
The surgeon places an adjustable band around the upper portion of the stomach to create a smaller pouch. |
Does Insurance Cover Bariatric Surgery?
Insurance coverage for bariatric surgery varies by plan and provider. Some insurance plans cover the procedure in full, while others may partially cover it or not cover it at all.
Insurance providers typically have specific criteria that individuals must meet in order for the surgery to be covered. These criteria may include a minimum body mass index (BMI) requirement, documentation of past weight-loss attempts, and a demonstrated need for the surgery.
It is important to check with your insurance provider to determine if bariatric surgery is covered under your plan and what the requirements are for coverage.
Insurance Providers that Cover Bariatric Surgery
Here are some insurance providers that cover bariatric surgery:
Insurance Provider |
Plan |
Coverage Details |
Blue Cross Blue Shield |
Most Plans |
May require a minimum BMI of 35, proof of attempted weight loss, and demonstration of medical need. |
Aetna |
Most Plans |
May require a minimum BMI of 35, proof of attempted weight loss, and demonstration of medical need. |
Cigna |
Most Plans |
May require a minimum BMI of 35, proof of attempted weight loss, and demonstration of medical need. |
Insurance Providers that Do Not Cover Bariatric Surgery
Here are some insurance providers that do not cover bariatric surgery:
Insurance Provider |
Plan |
Reason for Not Covering |
Medicare |
Most Plans |
Considers bariatric surgery to be a non-essential cosmetic procedure. |
Medicaid |
Most Plans |
May cover bariatric surgery in some cases, depending on the state and individual circumstances. |
United Healthcare |
Most Plans |
May cover bariatric surgery in some cases, but the individual must meet specific criteria and obtain prior authorization. |
FAQ
Is bariatric surgery covered by insurance?
Insurance coverage for bariatric surgery varies by plan and provider. Some insurance plans cover the procedure in full, while others may partially cover it or not cover it at all.
What are the insurance requirements for bariatric surgery?
Insurance providers typically have specific criteria that individuals must meet in order for the surgery to be covered. These criteria may include a minimum body mass index (BMI) requirement, documentation of past weight-loss attempts, and a demonstrated need for the surgery.
What insurance providers cover bariatric surgery?
Insurance providers that cover bariatric surgery include Blue Cross Blue Shield, Aetna, and Cigna. However, coverage may vary by plan and individual requirements.
What insurance providers do not cover bariatric surgery?
Insurance providers that do not cover bariatric surgery include Medicare and United Healthcare, although coverage may be available in some cases depending on individual circumstances.
How do I know if my insurance will cover bariatric surgery?
It is important to check with your insurance provider to determine if bariatric surgery is covered under your plan and what the requirements are for coverage.
In conclusion, insurance coverage for bariatric surgery varies by plan and provider. While some insurance providers cover the procedure, others may not. It is important to check with your provider to determine if bariatric surgery is covered under your plan and what specific requirements must be met for coverage. Bariatric surgery can be a life-changing procedure for those struggling with obesity, and insurance coverage can make it more accessible to those who need it.
Rekomendasi:- The Cost of Bariatric Surgery with Insurance Bariatric surgery, also known as weight-loss surgery, is a surgical procedure that helps individuals who are severely overweight or obese to lose weight. Over the years, bariatric surgery has become…
- Insurance that Covers Bariatric Surgery Obesity is a rampant health problem that affects millions of people across the globe. It is a condition that comes with a host of other health complications such as high…
- Bariatric Surgery Cost Without Insurance: Understanding the… Bariatric surgery, also known as weight loss surgery, is a medical procedure that aims to help individuals who are struggling with obesity achieve a healthy weight. This surgery typically involves…
- Weight Loss Covered by Insurance Obesity is a significant health concern in the United States, and it affects not only an individual's physical and mental well-being but also increases the risk of chronic illnesses like…
- Does Insurance Cover Skin Removal? Many people who have lost significant amounts of weight or undergone bariatric surgery are often left with excess skin that can be both uncomfortable and unsightly. Skin removal surgery (also…
- What Insurance Covers Cosmetic Surgery When it comes to cosmetic surgery, many patients wonder if their medical insurance will cover the cost of their procedure. The answer largely depends on the type of surgery being…
- Weight Loss Surgery Insurance Secrets Weight loss surgery can be a life-changing experience for those who struggle with obesity, but it can also be costly. If you're considering this type of surgery, you're likely wondering…
- BMI Insurance: A Comprehensive Guide BMI InsuranceBMI or Body Mass Index is a measure of body fat based on height and weight. It is widely used by healthcare professionals to determine whether an individual is…
- Gastric Sleeve Insurance Coverage Gastric sleeve surgery, also known as sleeve gastrectomy, is a weight loss procedure that involves removing a portion of the stomach to reduce its size. This surgery has been proven…
- VSG Surgery Cost with Insurance: Everything You Need to Know Vertical sleeve gastrectomy or VSG surgery is a weight-loss procedure that involves removing a portion of the stomach to reduce the amount of food it can hold, thereby helping individuals…
- Tummy Tuck Covered by Insurance: What You Need to Know If you're considering a tummy tuck, you may be wondering if insurance will cover the cost of the procedure. While a tummy tuck is typically considered a cosmetic procedure, there…
- Panniculectomy Covered by Insurance Excess skin and fat in the abdominal area are often a cause of concern for many individuals. They can be due to significant weight loss or pregnancy, and they can…
- The Cost of VSG Surgery Without Insurance: Understanding the… Weight loss surgery can be a life-changing decision for many people who struggle with obesity and related health issues. One popular option is vertical sleeve gastrectomy (VSG), which involves removing…
- Gastric Sleeve Cost With Insurance Gastric sleeve surgery, also known as sleeve gastrectomy, is a weight loss surgery that involves the removal of a portion of the stomach, resulting in a smaller pouch that restricts…
- Lap-Band Cost with Insurance If you’re considering a Lap-Band surgery, one of the significant factors you’re likely to consider is the cost. Undoubtedly, Lap-Band surgery is one of the most effective ways to lose…
- Does Insurance Cover Gastric Sleeve? Gastric sleeve surgery, also known as sleeve gastrectomy, is a weight loss surgery that involves removing a significant portion of the stomach. It is a common surgery for people with…
- Gastric Sleeve Cost Without Insurance: Everything You Need… Gastric sleeve surgery, also known as sleeve gastrectomy, is a weight loss surgery that involves the removal of a portion of the stomach. This results in the reduction of appetite…
- Lasik Eye Surgery Cost and Insurance Lasik eye surgery is a popular procedure that corrects the vision of those who suffer from nearsightedness, farsightedness, or astigmatism. It is a life-changing procedure that eliminates the need for…
- Abdominoplasty Covered by Insurance - What You Need to Know Abdominoplasty, commonly known as a tummy tuck, is a popular cosmetic surgery procedure that aims to remove excess skin and fat from the abdominal area, resulting in a flatter and…
- Does Insurance Cover Gastric Bypass? Gastric bypass surgery is a common procedure used to help people lose weight when traditional methods, such as diet and exercise, have proved ineffective. However, the costs associated with this…
- Breast Reduction Covered By Insurance Breast reduction surgery, also known as reduction mammoplasty, is a medical procedure that decreases the size of the breasts by removing excess breast tissue and skin. This procedure is typically…
- Does Insurance Cover Plastic Surgery? Plastic surgery is a cosmetic procedure that people undergo to enhance their physical appearance. It can be a great way to improve self-confidence and self-esteem. However, the cost of plastic…
- Cosmetic Surgery Insurance: What You Need to Know Undergoing cosmetic surgery can be an exciting but nerve-wracking experience. Not only are you making a significant change to your appearance, but you are also investing a considerable amount of…
- Does Insurance Cover Cataract Surgery? Cataracts are a common condition that affects many people, especially as they age. Cataract surgery is a common procedure used to treat this condition, and it's important to know if…
- Does Insurance Cover Breast Lift? Breast lift, also known as mastopexy, is a cosmetic surgical procedure that aims to raise and firm sagging breasts. According to the American Society of Plastic Surgeons, breast lift surgery…
- Does Insurance Cover Bunion Surgery? Bunions, also known as hallux valgus, are a common foot problem that can cause pain, discomfort, and difficulty walking. While non-surgical treatments such as wearing comfortable shoes or using orthotics…
- Breast reduction cost without insurance Breast reduction cost without insuranceMany women suffer from physical and emotional discomfort due to having large breasts. Breast reduction surgery, also known as reduction mammaplasty, is a popular solution for…
- Does Insurance Cover LASIK? For many individuals who have been wearing glasses or contact lenses for years, LASIK surgery provides a permanent solution to their vision problems. LASIK, which stands for Laser-Assisted In Situ…
- Is LASIK Covered by Insurance? If you're considering LASIK eye surgery, you may be wondering if the cost is covered by insurance. LASIK is an elective procedure, which means it's not typically covered by insurance.…
- Breast Reduction Insurance: What You Need to Know For many women, having large breasts can be a source of pain and discomfort. Breast reduction surgery, also known as reduction mammaplasty, can help relieve these symptoms by reducing the…