Do insurance companies cover surgery for obesity?

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If you are considering weight-loss surgery, check with your insurance company or your employer’s human resources department to find out if your health plan covers this procedure. 
All insurance companies require a BMI of 40+. A BMI of 35+ is sometimes allowed if you have co-morbid conditions. If your insurer covers weight-loss surgery, remember that you will have additional co-payments, and you may need a referral from your primary- care doctor. Medicare and some private insurance companies will only allow bariatric surgery at Centers of Excellence-designated facilities, so check the designation required by your carriers.
If your insurance does not cover bariatric surgery, explore other financial options with your surgeon’s office.
Most insurance companies will cover this surgery. Some will fight coverage, but we have had great success in getting insurers to realize that this is necessary. We give the insurance providers the information they need to understand why the surgery is necessary and what it involves. These operations are not being done for cosmetic purposes; they are being done to improve overall health and take the morbidity out of morbid obesity. Since bariatric surgery can actually reverse the risk of death, it is medically necessary. After significant weight loss there is often a lot of excess skin. Surgery to remove that skin will often not be covered by insurance. If, however, a hernia should have occurred after surgery and this requires additional surgery, removal of this skin can be done simultaneously and may be partially covered.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.