What insurance covers bariatric surgery

Weight loss surgery is a serious undertaking — physically, emotionally, and financially. Without health insurance, bariatric surgery is financially inaccessible for many people, a sad fact because weight loss surgery is often a medical necessity. 

For some, weight loss surgery is the last hope; the final road to freedom from health complications. Dr. Robert Snow, bariatric surgeon at Snow Bariatric Center in Fort Worth and Flower Mound, Texas, has seen the pure joy that comes with being free from those constraints, and he wants weight loss to be as accessible as possible. 

To navigate the beginning stages of weight loss surgery, it’s helpful to understand how — and if — insurance companies pitch in financially. 

Does insurance cover weight loss surgery?

Different insurance companies and policies cover different procedures, but in general, most insurance companies will at least partially cover the major bariatric surgeries: gastric bypass, gastric sleeve, and gastric band. 

How to get weight loss surgery covered by insurance

The best way to find out if your health insurance covers weight loss surgery is simply to ask. Your insurance very well might cover bariatric surgery as long as certain criteria are met. Often, the criteria required by health insurance companies are the same as what’s required to have bariatric surgery in the first place. 

Your insurance might request a referral from your primary care doctor, along with other documents that show your health history. Your insurance will probably want to know if you’ve tried to lose weight in the past, such as through diet, exercise, or prescription medications.

According to Duke Health, you will likely have to meet some or all of the following criteria in order to get weight loss surgery covered by your insurance: 

• Be over the age of 18

• Have a BMI of 40 or greater, or have a BMI of 35 or greater with a comorbidity such as diabetes or hypertension

• Diagnosis of morbid obesity

• Pass a psychological evaluation determining you’re emotionally fit to undergo weight loss surgery

• Don’t smoke or fully quit smoking before the procedure

• Willingness to complete a weight loss plan mandated by your insurance company before or after surgery

• Well-documented history of weight loss efforts

Even if your policy doesn’t cover weight loss surgery as-is, if you can provide evidence to your health insurance company that weight loss surgery is a medical necessity for you, you can likely get coverage.

Dr. Snow understands that this whole process can feel confusing and inundating. He and our expert staff are here to answer questions you have about weight loss surgery, health insurance, or anything else related to your weight loss journey.

If you want to talk through the financial process of weight loss surgery, schedule a consultation appointment with Dr. Snow today by calling one of our convenient Texas locations or request an appointment online.