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Does My Insurance Cover Bariatric Surgery?

“Does my insurance cover bariatric surgery?”

Weight loss can be difficult, and in some cases, you may be someone who requires the help of a medical professional to lose the weight.

Unfortunately, many are hesitant to pursue weight loss surgery due to the expectation that they won’t be able to afford it.

However, this is not always the case.

Look at Your Policy

The first thing you will want to do if you are considering bariatric surgery is to contact your policy provider to see if obesity or morbid obesity is covered under your plan.

If you have a BMI of 40 or more you will be considered to be morbidly obese. In this case, you should give your provider the following code to see if you are covered: E66.01.

If you are obese, the code you will need to give is E66.0.

Once you know if you are covered under your plan you can begin to ask questions about which weight loss surgery options will specifically be covered for you to choose from.

When is Bariatric Surgery Covered?

Different insurance providers will offer different requirements in terms of coverage for weight loss surgery.

Some of the most common requirements include the following:

  • You are over the age of 18

  • You classify as morbidly obese or obese

  • You have documented efforts to lose weight

  • You have undergone psychological testing

  • You have no history of substance abuse

What to Do if You Are Not Covered

If your insurance provider does not offer coverage for weight loss surgery you do have other options.

One option is to switch carriers during open enrollment.

You can also opt to pay cash without insurance or to participate in a weight loss program through your local surgery center.

Does My Insurance Cover Bariatric Surgery?

If you are interested in weight loss surgery at Northern Virginia Surgical Specialists, call today to learn more about your coverage and payment options, 540-347-2805.

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