Weight Loss Surgery Requirements For Insurance

For many people weight loss surgery is affordable because it is included in their health insurance coverage.

Weight loss surgery requirements for insurance. Bariatric and gastric bypass surgery isn t for everyone. Insurance coverage and requirements. In order to be pre approved for the procedure you must meet the following requirements.

In addition some weight loss surgeries alter the digestion process limiting the absorption of calories and nutrients. Today most insurance companies that cover weight loss surgery will cover gastric bands laparoscopic gastric bypass and gastric sleeve surgery. Medicare only covers certain types of weight loss procedures.

Whether your insurance company will cover the cost of bariatric surgery weight loss surgery or you are paying for it yourself. Only a few years ago the lap band procedure was considered experimental and not covered by most insurance companies. Bmi body mass index of 40 or above bmi between 35 and 39 9 with comorbidities such as hypertension diabetes sleep apnea cardiovascular disease etc.

However the generalizability of these findings is limited in that actual weight loss is typically not required for surgery or insurance coverage of surgery. Many insurance companies will provide coverage for weight loss surgery if it is considered a medical necessity and the patient meets the national institute of health nih requirements for bariatric surgery. Medicare covers weight loss surgery if you meet certain criteria such as having a bmi greater than 35.

The only available randomized clinical trial demonstrates the efficacy of a presurgical weight loss 10 of initial requirement in reducing body weight both pre and postsurgery. You ll likely also take part in nutritional and behavior classes to help you with the surgery and life after the surgery. To help with the insurance approval process send all documentation of previous weight loss attempts.

For other people it is a medical treatment they pay for themselves. Continued getting your insurance to pay for weight loss surgery. Proof that surgery or medical intervention is medically necessary.