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Weight Loss Surgery Insurance




Weight Loss Surgery Insurance

Morbidly obese people may be dissuaded from getting bariatric surgery due to its high cost but they can now afford it by means of weight loss surgery insurance. Patients who have insurance can find relief from the financial burden caused by weight loss surgery. Most insurers only cover a fraction of the total cost of the surgery but this has helped patients afford not only the surgery but the aftercare programme required right after the procedure as well.

Applying for weight loss surgery insurance coverage is a complex process. Patients should not allow this to prevent them from getting the treatment. Instead, they must look for other ways to get coverage or consider other funding options.

What are the qualifications for weight loss surgery insurance?



Qualifying for weight loss surgery is tough, and it gets even tougher with weight loss surgery insurance. Insurance companies may still use the same criteria set by the National Institute for Clinical Excellence for weight loss surgery which include:
  • Body mass index of over 40, which is equivalent to 80 to 100 pounds excess of the person’s ideal weight.
  • Body mass index of over 50, also considered as super obese.
  • Body mass index of 35 with the existence of the co-morbidities of obesity.


Insurers may also apply another set of criteria aside from these, so patients should contact their insurance providers to learn about the complete requirements for eligibility.

What does weight loss surgery insurance cover?



Insurance coverage differs between insurance companies.  But normally, insurance for bariatric surgery covers x-ray fees, pre-op laboratory tests, hospital facility, anesthesia, surgeon’s fee and type of procedure. Meanwhile, post-bariatric plastic surgery, aftercare programme and nutritional supplements may not be included.

What needs to be done to get weight loss surgery insurance?



Getting insurance coverage for weight loss surgery involves the following things.
  • Proving one’s health condition
    The patient must prove that weight loss surgery is medically necessary.  This can only be achieved by having the support of a bariatric surgeon through good medical documentation.

  • Preparing for a psychological evaluation
    Most insurers require their clients to undergo psychological and even nutritional evaluation to ascertain that they have the right motives and goals for having the procedure.

  • Providing vast amounts of documents
    Applying for weight loss surgery insurance coverage involves a lot of paperwork, such as proof of the patient’s previous weight loss attempts comprising of doctor-supervised weight loss diet, exercise programs and documentation of gym membership.

What to do if weight loss surgery insurance coverage is denied



Patients should expect denial on the first attempt to get insurance coverage despite meeting the criteria set by their insurance providers. In such case, the patient should file an appeal immediately citing further proof that weight loss surgery is medically necessary. If the request gets denied over and over again, the person should look for other ways to finance the surgery.  In this regard, his or her bariatric surgeon can be of great help in finding other suitable financing options.

Weight loss surgery insurance is a great way to reduce the heavy cost of this bariatric treatment. The individual should be optimistic even if the coverage gets denied and must look for alternative means to finance the procedure.


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