Many health insurance carriers do offer coverage for bariatric surgery. However, coverage is highly variable from plan to plan. Even if your health insurer does offer coverage, it’s possible that only certain procedures are covered, such as bariatric sleeve or gastric bypass surgery. When you talk to the surgeon’s staff and your health plan representative, you’ll need to find out if you must pay the deductible before coverage kicks in, and if co-insurance charges apply. The co-insurance is the percentage of the medical bill you’re responsible for paying, after you’ve paid the deductible. For example, the health plan may cover 80% of the remaining amount after the deductible, in which case your co-insurance is 20%.
If your plan does cover the procedure, you’ll still need to meet the eligibility criteria. These criteria are quite similar to the candidacy requirements for having the surgery, such as having a certain body mass index (BMI). In addition, your doctor might need to provide the health insurer with a letter stating that the procedure is medically necessary.
Call 713-339-1353 and ask the knowledgeable staff at Bariatric Care Centers for assistance figuring out your health insurance benefits. Our bariatric practice in Houston is committed to transparent billing practices, and we also accept medical financing.
Disclaimer: This is only for general information. All patients should consult their doctors prior to following any of the recommendations in any articles and videos. Every patient has individual needs and limitations that only their treating physicians can be aware of.