Weight Loss Surgery Insurance

Posted By on Sep 14, 2015 in Covered By Insurance, Plastic Surgery Blogs | 0 comments


During a weight loss surgery, or bariatric procedure, doctors make some changes to their patients’ stomach and/or small intestine in an attempt to improve their satiety. For the right candidates, studies have suggested the surgery can significantly improve their health, mobility, and overall quality of life.

Weight loss surgery insurance has become more accessible for obese patients after the passage of the Affordable Care Act (Obamacare) in which issuers from 23 states are required to cover the procedure’s cost for all Individual, Family, and Small Group Plans.

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Nevertheless, some insurance companies exclude weight loss surgery from their plans, while others have very stringent requirements that would make it next to impossible to receive pre-approval.

But to allay some concern, take note that many patients have successfully gain insurance approval after appealing the initial decision of their issuers and presenting additional evidence suggesting that their weight loss surgery is the only long-term, viable solution for their life-threatening weight-related health problems.

Aside from medical documentation, it is not uncommon for health insurance issuers to require their policyholders to have tried medically supervised weight loss options (which have failed) before coverage becomes even possible.

To increase your chance of pre-approval, ask your surgeon to contact your insurance company since his office will be very familiar with the requirements and the entire approval process. He can also send them letters of recommendations and complete documentation—such as diet and medical records, and previous attempts to lose weight—stating that your bariatric surgery is “medically” warranted.

Another viable option is to check your policy, including the “fine print,” and then contact your insurance company to ask for additional details.

Aside from your surgeon’s recommendation letter, other experts such as your nutritionist, dietician, and behaviorist’s “endorsement” verifying the medical necessity of your weight loss surgery insurance can also help build your case, increasing your chance of getting approved.

While many health insurance issuers now cover the cost of bariatric surgery, this is not the same with plastic surgery after weight loss, which is generally categorized as an elective procedure. Nevertheless, patients may resort to other financing options such as bank loans, regular credit cards, medical credit cards, home equity loans, unsecured medical loans, and doctor’s payment plans.

It has been well documented that plastic surgery after weight loss such as tummy tuck and lower body lift can serve as a strong motivation for post-bariatric patients to maintain a health, stable weight long-term.

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