Many insurance providers endorse all four major weight-loss surgeries (gastric sleeve, gastric bypass, lap band, and duodenal switch).
To be eligible for insurance, a patient generally needs to have a body mass index of more than 40. Anyone with a BMI between 35 and 39 with obesity-related ailments like sleep apnea, type 2 diabetes, heart disorders, and high blood pressure is also considered eligible.
Dietary and psychological assessments are necessary for every insurance plan. This is a major step that assists in making sure whether you are ready for the surgery or not.
How To Find Whether Your Insurance Covers Weight Loss Surgery Or Not?
- You must contact your provider and ask whether your policy covers obesity. If it does, you need to get the weight loss procedure covered by your individual insurance.
- Next, what you have to do is to ensure the kind of surgery you are considering is covered. You must use these codes to find whether your insurance covers a specific kind of weight loss procedure.
- Gastric sleeve: CPT 43775
- Gastric bypass: CPT 43644
- Duodenal switch (BD-DS): CPT 43645
- You also need to consider the requisites for bariatric surgery insurance. There are providers that have these requirements for bariatric surgery insurance coverage:
- The body mass index of the applicant must be more than 40 or 35 with any obesity-associated diseases such as high BP, diabetes, or sleep apnea.
- The applicant should have proof of weight loss attempts using the traditional methods in the past.
- The applicant should be more than 18 years of age.
- The applicant should have been undergoing serious obesity for a particular period prior to the operation.
What If The Insurance Does Not Cover Weight Loss Procedure?
In case you find that your insurance does not pay for bariatric surgery in Mexico, you can switch to other options. You can pay for the surgery using different methods, such as taking a medical loan or paying through cash. Consider discussing this with your insurance provider or company to get the right answer to your questions.
- Check the quality of the clinic you are selecting
- Check the experience of the surgeon
- Get referrals
- Go through the credentials of the bariatric surgeon
- Have a look at the past patient’s reviews