Does insurance cover weight loss surgery?

There are many states that have laws that require insurance companies to cover weight loss surgery if it is considered medically necessary and the patient meets the criteria set forth by the National Institutes of Health. Generally speaking, approximately 50% of insurance companies will cover a weight loss surgery including the LAP-BAND/REALIZE™ band, gastric bypass surgery, and gastric sleeve as long as the patient’s doctor provides a Letter of Medical Necessity.

A Letter of Medical Necessity is submitted to your insurance company and allows them to consider your request for surgery. The letter essentially addresses why weight loss surgery is critical for the health of the patient and why surgery is necessary. The Letter of Medical Necessity will include information such as the weight of the patient, including BMI, the number of years that the patient has been overweight, full medical history including conditions related to obesity, and diets and weight loss programs attempted by the patient in the past.

Of course, insurance coverage can be tricky business. Once you schedule an appointment, our insurance verifiers work with our patients step-by-step to provide their insurance company with what they need to help provide coverage.

Some insurance companies that currently provide partial or complete coverage of some weight loss surgeries include Blue Cross (in some states), Humana First Health, United Healthcare, Aetna, and Cigna.

However, be sure to check with your insurance carrier or human resource department to determine your specific insurance coverage for weight loss surgery.

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