Does Insurance Cover Weight Loss Surgery?

So, you’re considering weight loss surgery. Now that you’ve taken the first of several steps to start your body transformation, you may wonder if you can use insurance to cover your procedure. While most health insurers provide coverage for weight loss surgery, there are stipulations that patients must meet before that coverage applies. 

Here is some information that can help you better determine whether you can rely on your health insurance to help you afford the cost of weight loss surgery.

Weight Loss Surgery Is Medically Necessary and Cosmetically Rewarding

weight loss surgery insuranceWeight loss surgery offers patients both cosmetic and medical benefits. Many insurances cover weight loss surgery for patients experiencing a medical or health problem related to being overweight. Common health conditions that tend to improve with bariatric treatment include:

  • Diabetes
  • High blood pressure
  • Asthma
  • Arthritis
  • And more

Our insurance coordinator is available to help you learn if your health insurer covers weight loss surgery for your medical situation. They can help you make the best-informed decision regarding your care and make the necessary arrangements to start your weight loss journey with My New Beginning.

Review Your Insurance Policy

Most insurers and medical facilities require patients to meet specific criteria for weight loss surgery. Each insurer has different requirements that their policyholders must fulfill before their insurance kicks in to reduce their overall weight loss surgery costs. For example, some insurers require bariatric surgery patients to have a history of being morbidly obese for a specific number of months or years. In many cases, a medical history of unsuccessful weight loss of attempts is also required.

Most bariatric centers and weight loss clinics require potential candidates to meet the following requirements before insurance becomes an option.weight loss surgery insurance

  • Be 18 years or older
  • Have a 35 BMI or greater with a co-existing health condition like high blood pressure, diabetes, or fatty liver disease
  • Have a 40 BMI or greater without comorbidities
  • Meet the clinical threshold for morbid obesity diagnosis
  • Have a documented history of failed weight loss attempts
  • Undergo a medical and psychological evaluation
  • Willingness to commit to a long-term treatment plan
  • Willingness to stop or avoid smoking throughout treatment

Call your insurer to discuss your situation or carefully look over your insurance policy to see if it includes coverage for weight loss or bariatric surgery. Don’t forget to take notes and ask questions.

Though your procedure may be the solution to overcoming challenges that have stalled your weight loss success thus far, it’s essential to understand how much of your weight loss treatment is covered by your insurer. Some health insurance providers cover the entire cost of care. Others only cover a portion leaving patients with some out-of-pocket expenses. 

My New Beginning accepts many insurances, including most HMOs, PPOs, and Medicare. To learn if we take your insurance or if you have questions, don’t hesitate to give us a call. We are more than happy to assist.

How Much Does Weight Loss Surgery Cost?

Medical weight loss treatments range in price and can be quite expensive without insurance. The average price tag for bariatric procedures ranges from$17,000 to $26,000, according to ASMBS. That’s before any insurance coverage kicks in. Costs vary significantly and depend on a variety of unique factors for each patient, such as the type of bariatric procedure (gastric sleeve, gastric band, Duodenal switch, Roux-en-Y gastric bypass, etc.), insurance coverage, and anesthesia.

Patients planning to use their insurance for bariatric surgery should be aware that the price of their procedure may not be the same as the cash rate; insurers determine prices. Potential patients should speak with one of our representatives for a more definitive cost breakdown relative to their situation. Cash rates are available for anyone who qualifies for weight loss surgery but is not planning to use insurance.

How to Use Insurance for Weight Loss Surgery?

If you plan to use your health coverage for your bariatric procedure, review your insurance plan first or contact My New Beginning to speak with our insuranceweight loss surgery insurance coordinator for assistance. We are more than happy to go over your insurance coverage with you to help you learn of any out-of-pocket expenses you may incur during your weight loss journey with us. 

We screen potential candidates to ensure they are ready to commit to the process and make the necessary behavioral and lifestyle changes to improve their health and mindset to succeed in their weight loss goals. Health and mental fitness assessments are mandatory and vital components of the My New Beginning weight loss experience. Some of these assessments may not be covered by insurance.

Patients are expected to settle any costs not covered by their insurance before scheduling their surgery. If insurance is not an option, we offer cash prices and are more than willing to work with you to ensure you get the weight loss surgery you need for a better physique and optimal health. We also offer non-surgical weight loss programs for individuals interested in losing weight but who are not clinically obese or not quite ready to have surgery.

Start Your Weight Loss Journey With My New Beginning Today

Losing weight is not always easy, especially if there is a lot to lose. If you are overweight or obese and suffering from additional health challenges that make it difficult to succeed in this endeavor, weight loss surgery could be the answer. 

If you have questions about insurance and weight loss treatment, call (214) 324-6100 to speak to our insurance coordinator or make an appointment to discover surgical and non-surgical weight loss options that can transform your mind, body, health, and life for the better.