Weight Loss

Does Health Insurance Cover Weight Loss Surgery?

Does Health Insurance Cover Weight Loss Surgery

The simple answer is that it depends on the weight loss surgery procedure. Surgeons offer weight loss surgery at different prices. There are some weight loss surgeries such as gastric bypass, where insurance will cover all or part of the cost to get them covered.


A wage earner who has had no break in coverage and meets the eligibility requirements would qualify for health benefits within a 63-day waiting period. There are four different types of weight loss procedures covered by insurance: Gastric bypass, vertical sleeve gastrectomy, Lap Band and Roux-en-Y Gastric Bypass. The question of whether your insurance provider will cover your revision surgery is not an easy one to respond to.

Lap band surgery in Phoenix Arizona is considered one of the most cost-effective weight loss surgeries because it only requires 1-2 days in the hospital and relatively fewer complications than gastric bypass weight loss surgery. In addition, lap band weight loss surgery does not require overnight stays and the adjustable gastric band weight loss can be removed at any time.

Qualifications for Health Insurance Cover Weight Loss Surgery are:

Weight loss surgery is simply not a bailout; people need to qualify. Health insurance companies want healthier and productive workers who will generate more revenue over the long term. People with diabetes, high blood pressure, heart disease and sleep apnea are ideal candidates for weight loss surgery if they meet specific criteria. They may be able to get weight loss surgery covered by their health insurance policy.

A weight loss surgery candidate will have to meet all the following criteria:

– Your weight is at least 100 pounds over your ideal body weight.

– You have tried at least one year of conservative weight loss methods without losing more than 10% of your excess weight or meeting any other medical requirements.

– Your body mass index (BMI) is 35 or greater. A BMI of 30 to 35 is considered overweight and a BMI of 25 to 29 falls into the category of obesity.

– You have one or more serious diseases caused by your weight, such as type 2 diabetes, high blood pressure, obstructive sleep apnea, or heart disease.

– You have already tried and failed conservative weight loss methods, such as dieting (dietitian supervised) and exercise to no avail.

The surgeon will discuss results from the health tests performed on you during a consultation prior to scheduling your surgery. Health insurance coverage often depends on these initial medical evaluations. In addition, your surgeon will likely require that you meet strict medical criteria to determine whether you are a good weight loss surgery candidate.

TIP: Many people who qualify for insurance coverage discover that they have to buy the additional obesity rider.  The policy applies only after reaching one year of coverage. If you need health insurance weight loss surgery, you better do your homework to qualify for the insurance coverage.

Weight loss surgery is extremely expensive and ranges from $20,000 to more than $50,000 in total price depending on the procedure that you choose. Not everyone can afford to have weight loss surgery and that’s why there are a lot of people who are not able to get it.

Being able to qualify for insurance coverage is one thing but being insurable is another matter entirely. If a person has more than two health problems or risks, he might not be able to find a health insurance company that will provide coverage for weight loss surgery. It’s always advised to talk to your weight loss surgery clinic in phoenix and your insurance company to know if your surgery will be covered or not.