When is weight loss surgery covered by insurance?

What are the requirements for insurance to cover weight loss surgery?

How to get weight loss surgery covered by 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.

Is weight loss surgery ever covered by insurance?

Insurance is typically the best way to go when you are considering weight loss surgery. However, many procedures are not covered by insurance. … Today gastric sleeves, laparoscopic gastric bypass and lap gastric bands are typically covered by most major insurance companies.

How long does insurance take for weight loss surgery?

It can take two to four weeks for the insurance company to respond with a decision.

What if my insurance doesn’t cover bariatric surgery?

If your insurance does not provide coverage for bariatric surgery, there are other options available to you. Depending on plan language, consultations, nutritional counseling and pre- and post-operative tests, labs and follow-up visits may be covered, although surgery is not.

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How much does bariatric surgery cost out of pocket?

According to Obesity Coverage, a bariatric surgery information site, the average cost of lap-band surgery is $14,500, while gastric bypass costs an average of $23,000. The price tag might be gulp-inducing to you, and that’s understandable; it’s more than some new cars cost. However, it can be well worth the investment.

What can disqualify you from bariatric surgery?

These are as follows:

  • Drug and/or alcohol addiction.
  • Age under 16 or over 75.
  • History of heart disease or severe lung problems. …
  • Chronic pancreatitis (or have a history of this).
  • Cirrhosis of the liver.
  • Autoimmune disease such as systemic lupus erthyematosus.
  • Blood disorder which increases your risk of heavy bleeding.

What insurance pays for gastric sleeve?

Many PPO insurance providers are now providing coverage for Gastric Sleeve, Gastric Bypass, Distal Bypass and Lap-Band Removal. Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare and United Health Care typically cover weight loss procedures.

Does Blue Cross Blue Shield cover gastric sleeve surgery?

Gastric sleeve and gastric bypass are two of the leading procedures that are considered the safest and most definitive solutions to morbid obesity. The insurance companies in all the states cover these two procedures under Blue Cross Blue Shield bariatric surgery plans.

How many pounds overweight for gastric sleeve?

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

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How much weight do you have to lose before gastric sleeve?

Some patients are required to lose 10 percent of their weight before weight-loss surgery is performed. For other patients, losing just 15 to 20 pounds right before surgery is enough to reduce the risk of complications. It’s important to follow your surgeon’s pre-surgery diet and nutrition guidelines.

How much does it cost for weight-loss surgery?

Weight loss surgery can cost anywhere from $15,000 to $25,000 if you don’t have insurance. With private health cover, you can often cut this down by about two-thirds, as your insurance will pay for your accommodation, theatre fees, anesthesia and some doctor’s fees.