How To Find Out If Insurance Covers Weight Loss Surgery

by Al Paterson


Minimum requirements to qualify for gastric sleeve surgery include: a body mass index (BMI) of 40 or greater, OR a BMI between 30 and 39.9 with a serious obesity-related health condition such as diabetes, high blood pressure, high blood pressure, sleep apnea, high cholesterol, joint problems and many more.

Can weight loss be covered by insurance?

What types of weight loss treatments do insurers cover? The Affordable Care Act requires most health insurers to cover obesity screening and counseling as preventive care for adults and children. Dietary advice is also available for adults at increased risk of chronic disease.

Bariatric surgery under insurance?

Fortunately, as per the guidelines set by IRDAI (Insurance Regulatory and Development Authority of India) in 2019, bariatric surgery is included in health insurance. Therefore, it is usually mentioned as an inclusion in most health insurance policies.

Why isn’t obesity covered by insurance?

No. Obesity is considered a pre-existing condition under the Affordable Care Act (ACA). So, as with all pre-existing conditions, insurance companies cannot force people with a high BMI to pay more premiums.

How long does it take United Healthcare to approve bariatric surgery?

So how long does surgical insurance approval last? Most patients can get pre-approved for bariatric surgery in 90 days/12 weeks (with consecutive office visits) if there are no medical requirements of the weight loss program, but there is no there is no guarantee.

Who can’t do bariatric surgery?

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

How much do you have to weigh to be a candidate 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 apnea severe sleep. Weigh less than 450 pounds, the maximum weight the hospital X-ray equipment can support.

What is considered pre-existing for bariatric surgery?

Obesity is generally considered a pre-existing condition, so no exemption can apply to the 12 month requirement.

What is the name of the new weight loss drug?

In June 2021, the FDA approved semaglutide (Wegovy), a weekly injection, for chronic weight management when used in combination with a healthy diet and exercise. The drug made headlines before its approval when the manufacturer announced results of 15-18% weight loss during clinical trials.

Is obesity a disability according to IDEA?

Without evidence of an underlying disorder or physiological condition, extreme obesity is not a disability under the Americans with Disabilities Act (ADA), according to the United States Court of Appeals for the seventh circuit.


Although doctors have the right to choose their patients, recent stories of doctors refusing to treat overweight or obese people have raised questions about whether such practices constitute discrimination.

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