Most private insurance companies have requirements for bariatric surgery coverage.
The approval process is more complicated than it is for other surgery procedures. Most insurers will require:
- A letter of medical necessity from your primary care physician
- Documentation of your obesity-related medical problems
These requirements may vary with your situation, as different insurers have different requirements for bariatric coverage.
After obtaining the necessary documentation, the bariatric department will submit a request for authorization to your private insurance company.
Medicare covers some bariatric surgical procedures, like gastric bypass surgery and laparoscopic banding surgery, when you meet certain conditions related to morbid obesity. Generally, Medicare will generally cover gastric bypass surgery for individuals with a body mass index of 35 and at least one obesity-related health problem such as Type 2 diabetes, heart disease or sleep apnea. In addition, most gastric bypass candidates on Medicare must have completed a six-month medically supervised weight loss program through their bariatric surgeon or their primary care physician.
It is always best to check with your insurer before scheduling a bariatric surgery.