Bariatric Surgery Insurance Coverage

If you’re considering bariatric surgery as a solution for managing morbid obesity or obesity-related conditions, understanding your insurance coverage is crucial. Many health insurance providers cover bariatric procedures, but the process can feel complex. At Torrance Bariatrics Institute, we are in network with Anthem Blue Cross, Bluecross-Blueshield, UHC and Cigna. We also accept Aetna, Healthnet and BlueShield. It is important to check with our office to ensure your health policy covers your surgical procedure. Our office staff will happily check your insurance benefits.

Several factors are in play when it comes to insurance coverage. The most important factor is whether your insurance policy has “bariatric benefits.” Secondary factors such as your policy co-pay and out-of-pocket will play a role. Choosing an in-network provider who has adequate expertise and performs your surgery at a Center of Excellence can reduce costs and improve your outcome. Coverage also often depends on whether your medical condition meets specific criteria.

Procedures like Gastric Sleeve, Gastric Bypass, and Lap-Band surgery are commonly covered if deemed medically necessary. Medical necessity is determined based on factors such as your Body Mass Index (BMI), documented weight-loss attempts, and obesity-related health conditions, including but not limited to type 2 diabetes, cardiovascular disease, or high blood pressure, sleep apnea and gastroesophageal reflux.

Before your insurance provider approves bariatric surgery, you’ll need to meet specific requirements. These requirements might include preoperative work-ups, psychological clearance, preoperative endoscopy, meeting BMI and comorbidity criteria, and, if necessary, completion of diet and exercise sessions. Our team at Torrance Bariatric Institute is more than happy and committed to helping you throughout the process once our surgeons determine you are a qualified candidate for weight loss surgery. We can help you determine if your insurance company requires any deductibles or co-pays.