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 blood pressure, diabetes, and heart disease. If you have tried all means to lose weight but have not been successful, bariatric surgery may be an option for you. Bariatric surgery can be costly, but some insurance companies cover it. This article will guide you on the insurance that covers bariatric surgery and what you need to do to get covered.

What is Bariatric Surgery?

Bariatric surgery is a weight loss procedure that involves reducing the size of the stomach. This means that the amount of food you eat will be reduced, leading to weight loss. Bariatric surgery is recommended for people with a body mass index (BMI) of 40 or higher, but it can also be done for people with a BMI of 35 or higher if they have other obesity-related health problems.

The different types of bariatric surgery include:

Insurance Coverage for Bariatric Surgery

If you are considering bariatric surgery, it is important to find out if your insurance covers it. In the past, bariatric surgery was considered a cosmetic procedure, and insurance companies did not cover it. Today, most insurance companies view bariatric surgery as a medical necessity and cover it to a certain extent.

The amount of coverage you get depends on your insurance provider and your insurance policy. Some insurance policies cover the entire cost of surgery, while others cover a portion of it. It is important to read your policy carefully to understand what is covered and what is not.

Medicare Coverage for Bariatric Surgery

Medicare is a health insurance program for people who are 65 or older or have certain disabilities. If you have Medicare, you may be eligible for bariatric surgery coverage if you meet certain criteria. Medicare covers bariatric surgery for individuals with a BMI of 35 or higher who have at least one obesity-related health problem.

Medicare covers the following bariatric surgery procedures:

Private Insurance Coverage for Bariatric Surgery

Private insurance coverage for bariatric surgery depends on your insurance provider and your policy. Most insurance companies cover bariatric surgery to a certain extent, but the coverage varies. It is important to contact your insurance company to find out if your policy covers bariatric surgery and what the coverage is.

Your insurance company may require you to meet certain criteria before covering bariatric surgery. Some of the criteria include:

• Having a BMI of 40 or higher
• Having a BMI of 35 or higher with at least one obesity-related health problem
• Being unable to lose weight through diet and exercise
• Being committed to making lifestyle changes after the surgery

FAQ: Insurance Coverage for Bariatric Surgery

1. Is bariatric surgery covered by Medicaid?

Yes, bariatric surgery is covered by Medicaid in most states. The coverage varies by state, and you should check with your state’s Medicaid office to find out what is covered.

2. What if my insurance does not cover bariatric surgery?

If your insurance does not cover bariatric surgery, you can opt to pay for the procedure out of pocket. Bariatric surgery can be expensive, and you should weigh the costs and benefits before making a decision.

3. How much does bariatric surgery cost?

The cost of bariatric surgery varies depending on the type of procedure you choose, the surgeon’s fees, and the hospital fees. On average, bariatric surgery costs between $15,000 and $25,000.

4. Does insurance cover the cost of pre-operative and post-operative care?

Yes, most insurance policies cover the cost of pre-operative and post-operative care. This includes consultations with a nutritionist and psychologist, lab work, and follow-up appointments.

5. What if my insurance denies coverage for bariatric surgery?

If your insurance denies coverage for bariatric surgery, you can appeal the decision. You should gather all the necessary information, such as medical records and letters from your doctor, and submit an appeal to your insurance company.

Conclusion

Bariatric surgery is a weight loss procedure that can help you lose weight and improve your health. If you are considering bariatric surgery, it is important to find out if your insurance covers it. Medicare covers bariatric surgery for individuals who meet certain criteria, while private insurance coverage varies. Make sure to read your policy carefully and contact your insurance company to find out what is covered and what the coverage is. With the right insurance coverage, you can get the bariatric surgery you need to improve your health and quality of life.