Can your Insurance Cover your Procedure?

If you are reading this text, its because you might be considering or have considered weight loss surgery, also called bariatric surgery. The price of your weight loss surgery will depend on several factors:

• The type of surgery you're having. Types of weight loss surgery include gastric bypass, adjustable gastric banding, vertical gastric banding (also called stomach stapling), sleeve gastrectomy, and biliopancreatic diversion. Other options include intragastric balloons or even an electric Implant device. Each has a different fee.
• Your surgeon's fee. This will vary based on the procedure’s complexity.

Aetna – Requirements for Weight Loss Surgery

Aetna covers most weight loss surgeries. However, you should note that most Aetna HMO and QPOS plans exclude coverage of surgical operations for the treatment of obesity unless approved by Aetna. Make sure you contact Aetna directly to find out if you policy includes weight loss surgery coverage.

Aetna Pre-approval requirements

To qualify for weight loss surgery and have it covered by Aetna, you must meet these requirements.

BCBS of Texas – Criteria for Weight Loss Surgery Coverage

Blue Cross Blue Shield of Texas (BCBSTX) covers weight loss surgery. However, some policies do specifically exclude weight loss surgery. Contact your insurance customer service to find out if your policy has a specific exclusion for weight loss surgery.

Blue Cross Blue Shield of Texas' Criteria for Insurance Coverage

To qualify for weight loss surgery and have it covered by Blue Cross Blue Shield of Texas you must meet these requirements.

Cigna – Requirements for Weight Loss Surgery

Most policies with Cigna cover weight loss surgery. However, some benefit plans do specifically exclude bariatric surgery. Contact Cigna directly to find out if your plan includes weight loss surgery coverage. Cigna recently merged with Great West Healthcare. The following applies to Great West Healthcare as well.

Cigna Pre-approval Requirements

Unless weight loss surgery is specifically excluded from your policy, you must meet these requirements to have it covered by Cigna.

United Healthcare's Criteria For Weight Loss Surgery Coverage

While many United Healthcare Summary Plan Descriptions and Certificates of Coverage explicitly exclude coverage for weight loss surgery, many plans do cover surgery. In fact, some states require insurance companies to cover weight loss surgery, so even if your policy excludes it, if your state mandates coverage you may be in luck!

United Healthcare’s Pre-approval Criteria For Surgery

To qualify for weight loss surgery and have it covered by United Healthcare, you must meet these requirements.

Medicare's Criteria For Weight Loss Surgery Coverage

Medicare covers weight loss surgery in most cases assuming you meet the coverage requirements. Not every weight loss procedure is covered either. If the criteria are met, Medicare covers Gastric Bypass, Lap Bands and Gastric Sleeve surgeries.

Medicare pre-approval requirements

To qualify for weight loss surgery and have it covered by Medicare, you must meet these requirements.