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Does insurance cover weight loss surgery?

Before and After BMI

December 15, 2023

Does insurance cover weight loss surgery?

Obesity is a complex and serious medical condition that affects millions of people around the world. It is associated with a number of serious health risks, including heart disease, stroke, diabetes, obstructive sleep apnea, and certain types of cancer. In addition to these physical health risks, obesity can also have significant social and psychological effects, including depression, anxiety, and social stigma.

One of the most effective ways to address obesity is through weight loss surgery. Also known as metabolic or bariatric surgery, this type of surgery is designed to help patients lose weight by reducing the size of the stomach or altering the way the body absorbs food. There are several different types of weight loss surgery, each with its own benefits and risks.

The most popular type of weight loss surgery is gastric sleeve, also known as sleeve gastrectomy. In this procedure, a large portion of the stomach is removed, leaving a smaller, sleeve-shaped stomach. Like gastric bypass surgery, sleeve gastrectomy restricts the amount of food a patient can eat and helps them feel fuller more quickly.

Another common type of weight loss surgery is gastric bypass surgery. This procedure involves creating a small stomach pouch and rerouting the digestive system so that food bypasses most of the stomach and small intestine. This reduces the amount of food that a patient can eat and limits the absorption of calories.

Duodenal switch surgery is a minimally invasive weight loss procedure that combines qualities of both the sleeve gastrectomy and the gastric bypass. DS surgery involves removing a portion of the stomach to reduce its size and rerouting the small intestine to limit the absorption of calories. It combines restrictive and malabsorptive elements to help patients achieve significant weight loss and improve obesity-related health conditions.

Gastric band surgery, also known as LAP-Band, is another type of weight loss surgery that involves placing a band around the upper part of the stomach to create a small pouch. The band can be adjusted over time to control the amount of food that a patient can eat.

What qualifies you for weight-loss surgery?

To qualify for weight loss surgery, patients must meet certain criteria, and insurance coverage for the procedure varies by plan and by state. Learn more about insurance coverage, including SurgeryPlus benefits. They must have a Body Mass Index (BMI) of 35 or higher, or a BMI of 30 or higher with at least one obesity-related health condition such as type two diabetes, high blood pressure, or sleep apnea. Patients must also have tried other weight loss methods such as diet and exercise without success.

What Insurance Covers Bariatric Surgery in Texas?

Weight loss surgery can be expensive, but many health insurance companies do cover bariatric surgery costs. However, coverage varies by insurance plan and by state, so it’s important to check with your insurance provider to see if weight loss surgery is covered under your plan. We can help you do this! In some cases, patients may also be required to meet additional criteria such as attending a weight loss program or undergoing psychological evaluation before the surgery can be approved.

Morbid obesity is a serious medical condition that can have significant health risks and impacts on a person’s social and psychological well-being. Weight loss surgery can be an effective way to address obesity, and there are several different types of surgery available. To qualify for weight loss surgery, patients must meet certain criteria, and insurance coverage for the procedure varies by plan and by state.

Don’t have insurance or can’t get them to cover your procedure? Click here to learn more about our Self Pay options: Bariatric Surgery Payment Plan

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