Will insurance cover gastric sleeve?

Own list · Average cost of gastric surgery. Bariatric surgery insurance coverage varies depending on the insurance policy. If your policy covers weight-loss surgery and you meet the qualification requirements, most plans will pay for gastric sleeve surgery, gastric bypass, lap band, or duodenal replacement surgery. Many patients decide to have cosmetic surgery after bariatric surgery to remove excess skin.

In general, insurance companies don't cover cosmetic surgeries, unless they're necessary to solve a medical problem, such as problems with skin folds. It's important to discuss these questions with your doctor and health plan. Contact your insurance company to determine if elective bariatric surgery is a benefit covered under your plan, he said. As a result, many insurance providers offer coverage for a gastric sleeve procedure, but you should check with your insurance provider to see what your plan covers.

Most Aetna HMO and POS plans exclude coverage for surgical operations, procedures, or treatment for obesity unless approved by Aetna. If you have short-term disability insurance through your employer, you may be able to receive a portion of your monthly salary while you undergo surgery and recover from it. You can also call a couple of local bariatric surgeons and their staff will check if you have coverage. When bariatric surgery is required and is medically necessary, customers should consult coverage documents, call their provider, or see their doctor to verify coverage and any limitations before undergoing surgery.

However, most insurance plans require the patient to pay part of the costs in the form of copayments, deductibles and coinsurance. Some insurance companies have a mandatory three-month weight management protocol that you must complete before surgery. Insurance companies cover the cost of gastric sleeve surgery if you meet certain pre-specified criteria, which vary from company to company. Today, most major insurance companies usually cover gastric sleeves, laparoscopic gastric bypass and even if your body mass index (BMI) classifies you as morbidly obese, that doesn't mean your health insurance company approves bariatric surgery.

Require health plans that meet ACA requirements to cover weight-loss surgery for all patients who The ASMBS said the most common reasons patients don't undergo laparoscopic gastric bypass surgery are denial of insurance and lack of prior authorization. For example, Blue Cross- Blue Shield Arkansas requires a BMI of 60 or more to cover gastric sleeve surgery. While most insurance companies offer some form of weight-loss surgery coverage, your individual policy details what it includes and what it doesn't.

Marcie Macvicar
Marcie Macvicar

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