Will My Insurance Cover Weight Loss Surgery?
That's a really good question. Before we get into that, let's make sure you qualify for weight loss surgery first. Insurance companies require that a person's BMI (Body Mass Index) be 40 or greater. Often, we can get a weight loss surgery procedure covered if a patient has a BMI of 35 - 39.9 and also has one or more of the following medical conditions: High Blood Pressure, Sleep Apnea or Diabetes.
BMI, or Body Mass Index, is one of the indicators that insurance companies consider when determine eligibility for weight loss surgery.
Most insurance plans require that your BMI be 40 or higher. However, if your BMI is between 35 - 39.9, we can sometimes get you approved if you have a life-threatening medical condition, such as high blood pressure, diabetes or sleep apnea.
To compute your BMI, use the calculator on the to right to determine your current BMI or go to the BMI for Adults widget on the CDC website.
If your BMI was over 40, or between 35 - 39.9 (with at least one of the above-mentioned illnesses), let's move on to the next step, which is determining if your insurance covers weight loss surgery.
By using the Insurance Review Form in the Patient Profile Packet, you will know if your policy has benefits for weight loss surgery. If it does and you want to proceed, send in your Patient Profile Packet and the Insurance Review Form. We will screen your health history to make sure you are an appropriate candidate and our Insurance Team will make sure you meet the criteria set forth by your insurance policy. Assuming you meet all criteria, we will call to schedule your first appointment, where you will receive a personalized benefits form that will estimate, to the best of our abilities, your total out-of-pocket expenses.
You will also need to complete a seminar, either in-person at our facility, or online. Click here for our on-site schedule, or here to begin our online seminar.
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