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A male jogger takes steps to live a healthy lifestyle after undergoing weight-loss surgery.

Insurance and payment options for weight loss surgery

We know how important bariatric surgery is to you. It can be a matter of life and death. That’s why we’ll do everything in our power to help you qualify for insurance coverage.

Bariatric surgery is covered by most insurance companies. Sometimes it takes evidence and additional documentation to get approval for medical weight loss surgery. We have experienced insurance experts who know how to provide proof that your surgery is a medical necessity.

Insurers need to understand that we’re treating a life-threatening disease. They need to know that you have not chosen bariatric surgery for cosmetic reasons, but to reduce or eliminate disease, joint damage, and the negative impact on your life expectancy. By providing the medical facts about your situation, we can present convincing reasons for medical weight loss surgery.

Be aware though, gastric sleeve surgeries are fairly new procedures and are sometimes not covered by insurance companies. Over time, as long-term data becomes available, we expect more insurance companies to cover these life-changing bariatric surgeries.

Frequently asked questions about paying for bariatric surgery

Even with insurance coverage, bariatric surgery can involve out-of-pocket expenses such as deductibles, copayments, and coinsurance. These costs vary widely and depend on your insurance plan. It's essential to review your policy and discuss potential expenses with your insurance provider.

Insurance companies typically have specific criteria for bariatric surgery approval. These criteria may include a minimum Body Mass Index (BMI), documented previous attempts at weight loss, and documented obesity-related health conditions. Your health care provider and insurance company can provide detailed information on the specific requirements.

If your insurance denies coverage for bariatric surgery, you have the option to appeal the decision. This process typically involves gathering additional medical documentation and working with your health care provider to demonstrate medical necessity. Your insurance provider can guide you through the appeals process.

Post-operative costs may include follow-up appointments, nutritional supplements, and dietary modifications. It's important to budget for these ongoing expenses as part of your overall bariatric surgery plan.

Insurance coverage for revision surgery varies and depends on the reason for the revision, your insurance policy, and medical necessity. It's important to work closely with your healthcare provider and insurance company to determine coverage for revision surgery.

In many cases, HSA and FSA funds can be used for eligible medical expenses, including bariatric surgery and associated costs. Check with your HSA or FSA administrator for specific guidelines and documentation requirements.

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