Bariatric Surgery Insurance Coverage

If you’re considering bariatric surgery, you may be wondering if there is any insurance coverage to help alleviate the cost. While some insurance companies will help pay for a bariatric procedure, your chances of having surgery covered are best if your bariatric surgeon will help you make a case for the medical necessity of your procedure. Learn more about how Dr. Bass will help you work with your insurance company to increase the chances of having your bariatric surgery covered.

In most cases, bariatric surgery insurance coverage requires that you prove that:

  • You are morbidly obese. Your bariatric surgeon will take measurements to determine your body mass index (BMI). A BMI of 40 or higher is considered morbidly obese.
  • You have been obese for 5 or more years.
  • You have attempted and failed to lose weight without bariatric surgery in the past.
  • You suffer from co-morbidities, or medical complications caused by obesity. These may include hypertension, diabetes, sleep apnea, degenerative arthritis, or heart disease.
  • You do not have major psychiatric or emotional problems.

A bariatric surgeon like Dr. Bass can determine which criteria you meet by reviewing your medical history, completing a physical exam, and running some diagnostic tests. If your insurance denies coverage for bariatric surgery, you can still file an appeal with your surgeon’s help.