For millions of Americans who are struggling with obesity, diet and exercise may not be effective enough for them to lose the weight they need. Bariatric (weight loss) surgery can help them gain a new lease on life and dramatically reduced their chances of getting diseases such as high blood pressure, diabetes and heart disease.
But does insurance cover weight loss surgery? And how much does weight loss surgery cost? We’ve answered these questions as well as provided a useful quiz that can help you determine if your health insurance is likely to cover this surgery.
Do You Meet the Weight Loss Surgery Requirements? Talk With Your Health Insurance Representative
This is one of the most important questions you can ask concerning whether or not your insurance will cover weight loss surgery. In order for it to be covered, health insurance companies frequently require that an extensive set of criteria must be met.
Does insurance cover weight loss surgery? It depends upon whether or not you meet the qualifications.
Health care plans also change from time to time, and what may have been covered last year, won’t be included in the current year. The same goes for doctors—some may change as to whether they are in or out of network.
If you have a question about pre-authorization, we urge you to also speak to us. We can help you navigate the often-confusing world of health care insurance.
One important note: While this quiz is an excellent guideline, it’s no substitute for actually speaking with your health care insurance representative. They will have the latest information you need in order to make your decision.
Does Insurance Cover Weight Loss Surgery? Our Useful Quiz
Answer the following questions to see if it is likely that your insurance will pay for weight loss surgery.
1. Are you over 18?
In order to qualify, most insurance companies require that you are over the age of 18.
2. Is your BMI 40 or greater?
BMI stands for body mass index, and it evaluates your weight in relation to your height. If you’re not sure of what your BMI is, you can use this handy calculator.
3. Is your BMI 35 or greater WITH a serious, chronic health condition.
By chronic health condition, we mean something like diabetes or high blood pressure. We’ll document and evaluate you for this condition.
4. Have you received psychological counseling or testing?
Does insurance cover weight loss surgery? It depends upon if you’re willing to make the commitment to lifestyle changes that are needed after surgery.
Weight loss surgery is a serious commitment. It transforms your entire life and will dramatically change the way you eat after the procedure. It’s important that you are mentally ready for the challenge as well as physically ready. Most insurance companies require some type of documentation that indicates you will and are able to follow through with the stringent post-op instructions.
5. Have you tried to lose weight before weight loss surgery?
This is a very important point that insurance companies typically look for before granting permission for bariatric surgery. You must have documented evidence that you have tried –unsuccessfully—to lose weight beforehand.
Sometimes, this may take the form of a weight loss plan mandated by your insurance company.
Does Medicaid Cover Weight Loss Surgery?
In general, Medicaid will cover weight loss surgery, but there are several criteria that have to be met. We suggest you speak with your Medicaid representative to ensure you have the latest up-to-date information.
How Much Does Weight Loss Surgery Cost?
This depends upon several factors, so it’s difficult to give one final answer on how much is weight loss surgery. Primarily this is because we offer different types of bariatric (weight loss) surgery, and the price may vary depending upon the technique used.
How much weight loss surgery is and your out-of-pocket cost will also depend upon your insurance coverage.
Does insurance cover weight loss surgery? It may depend upon the type of weight loss surgery your doctor recommends. If you have concerns over how much the surgery will cost, please talk to us and we can assist you.
Does Insurance Cover Weight Loss Surgery? Yes, It Does
Conway Medical Center Has the Leading Weight Loss Surgery Program in the Horry County and Myrtle Beach Region
Did you know that we are the only program in the region that has received the honor of being accredited as a Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®)? This is a comprehensive program outlined by leaders at the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).
But what does this mean for you?
It means we’ve been recognized for excellence in every facet of our services. Weight loss surgery requires a lot of patient education and guidance, both before and after the procedure, and our compassionate staff has demonstrated time and time again that the wellness of our patients is our first priority.
If you’ve been pondering over the question “Does insurance cover weight loss surgery?” we want you to know that we’re dedicated to helping you work with your insurance company to help ensure you get the answers you need.