Will my insurance cover Gastric Sleeve Surgery?
As the popularity of the Gastric Sleeve grows and more procedures and studies are being completed, many insurance companies are now covering all or the majority of costs related to gastric sleeve surgery. Numerous companies, including Aetna, Anthem Blue Cross or Blue Shield, Cigna, Emblem, HealthNet, Priority Health and United Healthcare all cover all or portions of gastric sleeve surgeries for patients that can meet certain requirements.
Almost all PPO Insurance companies recognize the necessity of the Gastric Sleeve operation for patients who have been unable to find success using other non-surgical weight loss methods. They understand that as you lose more weight, the less likely it is that you will suffer from other obesity-related conditions, such as type 2 diabetes, hypertension and obstructive sleep apnea.
Schedule a Free ConsultationContact Us
What options do I have if my insurance won't cover the Gastric Sleeve?
Don't worry if you are convinced your insurance company will not cover the surgery. There are numerous actions to consider before determining what will or will not be covered. Your surgeon can also provide you with a "letter of medical necessity". Note many insurance agencies actually require this document prior to approving bariatric surgery, so keep it in mind when first talking to your surgeon. This document includes your personal information, your medical history in regards to attempted weight loss and your body mass index. It will also detail any health issues related to obesity and how being overweight affects your daily life.
Additional letters can be an incredible help in convincing your insurance company to cover the Gastric Sleeve surgery. Ask all doctors and medical professionals that have treated you for obesity-related problems for letters similar to the above and any documentation supporting the same. It is also very important to maintain records of every attempt at weight loss, as this will all support your claim that the surgery is a medical necessity.
All details in coverage vary from one carrier to another. Some companies cover the cost based on a minimum Body Mass Index of 40, while others require a much higher BMI. Certain companies also have specific insurance plans for bariatric surgeries, often labeled as "gastric insurance" or "gastric bypass insurance".
If paying cash is your only option, take note that there are additional costs that may not be included, including complications with the surgery, or post-surgical programs. Talk with your medical professionals, as many surgical centers offer independent insurance counseling and "reinsurance" plans that can cover complications. Also, numerous centers have an insurance specialist on staff that can guide you through any troubles with your agency.
Always remember your surgical staff is there to help you achieve your weight loss goals with as little confusion and difficulty as possible.
Gastric Sleeve Insurance experts are available to answer all your questions and make you feel comfortable about your weight loss procedure. Just call 1-855-690-0559 or fill out our No Obligations Gastric Sleeve Insurance Verification Form.