What Insurance Covers Weight Loss Surgery?

Posted by Patrick Domkowski on Wed, Jul 05, 2017

If you are considering bariatric surgery, you probably know that it is difficult decision to consider. Additionally, weight loss surgery is not necessarily the cheapest procedure to undergo, and you may ask yourself, “how will I be able to cover this” and “what insurance covers weight loss surgery?”

Coverage varies by policy, so it can get to be a little tricky when determining a budget. Fortunately, there are many insurance companies with a variety of plans that can assist you in making the procedure more affordable. Once you have received approval for the surgery, you can now start to consider the financial basics. Here are a few simple ways to narrow down your search, as well as your budget:

  1. Call your insurance company  Depending on which surgery you want to have, gastric bypass versus gastric sleeve, there is a “CPT code” associated with that surgery. For the laparoscopic bypass it is 43644 and for the laparoscopic sleeve gastrectomy it is 43775. Simply ask them if you have coverage for these codes and if you do what the requirements are.
  2. Your surgeon’s office staff can call your insurance provider on your behalf.

Most surgeons will contact your insurance company for free to confirm your bariatric surgery coverage. Their office has more than likely made this type of phone call before, so they are experienced in contacting insurance companies and understanding the insurance language.

guide-getting-approval-weight-loss-surgery

In addition to finding out what services your health insurance provides, it’s also important to note what exact procedures they are able to cover. Remember: coverage varies by policy. If you meet the coverage criteria, most health plans that provide bariatric surgery insurance will cover the following procedures:

Other procedures are usually not covered by insurance, but have discounts, tax savings, and financing available. Below are the procedures most insurance companies will NOT cover:

It’s important to keep in mind that not all insurance plans are the same. Contacting your health insurance provider will help you better establish the price point of your procedure and how you’ll be able to afford it. With assistance from your insurance provider, as well as your surgeon, you can diminish the stress of any potential financial burden following your surgery. Weight loss surgery can be a stressful procedure in the moments leading up to it, during the process, and the following days. It may seem difficult at first, but you do not have to go through it alone! Your insurance provider and your bariatric surgeon will work with you to make your dreams of a healthy life a reality.

 

Tags: Weight Loss Surgery Covered by Insurance

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