Does Medical Cover Weight Loss Surgery

by Al Paterson

Introduction

What kind of weight loss treatments do insurers cover? The Affordable Care Act requires that most health insurers cover obesity screening and counseling as preventive care for adults and children. Diet counseling is also available for adults at higher risk for chronic disease.

Does bariatric surgery under insurance?

Fortunately, as per the guidelines put forth by IRDAI (Insurance Regulatory and Development Authority of India) in 2019, Bariatric Surgery is included in health insurance. Thus, it is usually mentioned as an inclusion under most health insurance policies.

How do I get on the weight loss surgery list?

Speak to a GP if you think weight loss surgery may be an option for you. If you qualify for NHS treatment, they can refer you for an assessment to check surgery is suitable. You can also pay for surgery privately, although this can be expensive.

How big do you have to be for bariatric surgery?

Have a body mass index (BMI) of 35 or higher, or have a BMI between 30 and 35 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea. Weigh less than 450 pounds, the maximum weight that hospital radiology equipment can accommodate.

Is Medi Weight Loss a contract?

No. Patients of Medi-Weightloss® are not required to sign a contract or pay in advance. Some locations offer money-saving value and loyalty plan options that do require advance payment.

When should I seek medical help to lose weight?

If you’re losing weight without trying and you’re concerned about it, consult your health care provider. As a rule of thumb, losing more than 5% of your weight over 6 to 12 months may indicate a problem.

Who Cannot do bariatric surgery?

But why might a patient not qualify for bariatric surgery? BMI: First and most obviously, they simply may not have a BMI that is high enough. A BMI of 35 or more with one or more obesity related conditions or BMI of 40 or greater regardless of obesity related conditions is required to have surgery.

Who is a good candidate for bariatric surgery?

Body weight greater than 100 pounds or 45 kg above ideal weight. Body Mass Index (BMI) greater than 40 or BMI greater than 35 with medical complications related to obesity, including high blood pressure, type 2 diabetes, sleep apnea and gallbladder disease.

Is VSG surgery covered by Medi Cal?

Medicare and Medi-Cal

Medicare covers some bariatric surgical procedures if you meet certain conditions related to morbid obesity. Recently, Medicare expanded its coverage to include vertical sleeve gastrectomy. Medi-Cal only covers the cost of surgery in certain California counties.

What is the downtime for weight loss surgery?

Most people stay in the hospital for 2 to 3 days, and get back to normal activities in 3 to 5 weeks. If the surgery must be “open,” meaning the surgeon has to make a larger cut, healing takes longer.

Conclusion

In order to qualify for this surgery, you will have to prove that your attempts at weight loss have been exhausted by going through an official referral from your doctor as well as completing 6-12 months’ worth of dieting before even being considered. Candidates could wait 18+ months.

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