Today, most insurance companies that cover weight-loss surgery provide coverage for gastric bands, laparoscopic gastric bypass, and other procedures. Just a few years ago, the lap band procedure was considered experimental and was not covered by most insurance providers. However, insurance companies that do cover bariatric surgery have different requirements. Some may require medical records documenting that you have medical problems caused by your weight or records of your participation in physician-supervised weight-loss programs.
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. Insurance coverage for bariatric surgery varies by policy. If your policy covers weight-loss surgery and you meet the qualification requirements, most plans will pay to have gastric sleeve, gastric bypass, abdominal band, or duodenal change surgery. If you plan to have your surgery covered by insurance, you must complete the authorization process required by your insurance company. 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.
Due to the passage of the Affordable Care Act (Obamacare), insurance companies in 23 states are required to cover weight-loss surgery for all individual plans, family plans, and small group plans (employers with fewer than 50 full-time employees). Before you look up your insurance company's specific coverage requirements for weight-loss surgery, you should know if your specific policy covers them. While most insurance companies offer some type of weight-loss surgery coverage, your individual policy details what is included and what is not included. Click the “Uninsured” button on the tool to compare the national average self-pay costs for each procedure. Fortunately, many insurance companies recognize the serious health threats of obesity and cover weight-loss surgery as long as you meet qualification requirements.
A study shows that the average time from when weight-loss surgery is considered until the procedure is actually performed is 3 years. Weight loss procedures are typically covered by Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare, and United Health Care. But when you have a lot of weight to lose and exercise and diet aren't enough, you can consider weight-loss surgery - also known as bariatric surgery. Most insurance companies recognize that people who are overweight and obese are more likely to have serious health problems such as type 2 diabetes, high blood pressure, heart disease, high cholesterol and sleep apnea. Some insurance companies have a mandatory three-month weight-management protocol that you must complete before surgery.
So before you get too involved take time to determine if your insurance will cover weight-loss surgery.