Every insurance provider has different criteria for bariatric surgery. If you are considering bariatric surgery, be sure call your insurance company to find out about coverage for the surgery and related costs, as well as any stipulations that may exist.

Cost of bariatric surgery

The cost of bariatric surgery can range from $17,000 to $30,000. Be aware that even if your insurance company does pay for the surgery, it may not cover post-operative care such as therapy, diet and fitness plans, or plastic surgery to remove excess skin.

Coverage level

Some insurers may cover the entire surgery, while others may pay only a certain percentage of what is considered "customary and usual" for the procedure.

Medicare

Medicare will cover gastric bypass, gastric banding, or biliopancreatic diversion for patients with a body mass index (BMI) of 35 or greater, with at least one other obesity-related health problem.

Private Insurance

Private insurance companies may cover the surgery if your doctor can provide documentation that shows the surgery is medically necessary. Your doctor may need to submit a letter stating your weight, BMI, current medications, other health conditions and evidence of past attempts to lose weight.

What you can do

To increase your chances of obtaining approval for your gastric bypass surgery, keep all documentation for health conditions related to obesity. Be sure to comply with all insurance requirements, such as psychological evaluations.

Source:

Consumer Guide to Bariatric Surgery: Weight Loss Surgery Insurance Coverage