What Weight-Loss Surgeries Will Health Insurance Cover

America is facing a rampant increase in the problems of obesity, and more and more people are being put in a position wherein they have to seek medical treatment for their weight gain. Weight loss surgeries have come a long way since they were first introduced, and today, patients have access to a wide range of options that can help them get the body that they want.

Because of the potential risks that one faces when entering the category of obesity, the medical industry identifies this as an incredibly severe condition, which is why doctors are quick to recommend some remedial measures to take care of the problem that one might be facing as a result of excess weight. However, not all insurance companies share this common opinion about weight loss surgeries, and sometimes they tend to impose harsher restrictions on the coverage that one can get for weight loss surgeries under their plans.

Getting Health Insurance
Gaining good health insurance is an absolute necessity in today's world because of the ever-growing cost of health care in the country. Prices for checkups, medications, and more are skyrocketing. People are consistently put into a position wherein they have to rely on their health insurance provider to be able to cover the costs of any treatment or surgery that they would need. For life-saving treatments, in particular, having health insurance can be the difference between someone getting the care that they need and someone not being able to afford the cost of the treatment.

Weight Loss Procedures Commonly Covered By Health Insurance
When it comes to weight loss procedures, there are four main kinds that health insurance providers are ready to provide coverage for. These include the Sleeve Gastrectomy, Gastric Bypass, Duodenal Switch, and Lap-Band. Usually doctors will recommend one of these four options for a patient to go in for, depending on their individual needs. However, there are certain instances in which other procedures may be offered, which is mainly in severe cases. In these instances, the health insurance company is the one who can decide whether or not they should provide the insurance.

Coverage Based On Type Of Insurance
In America, the coverage of a weight loss surgery is mainly dependent on the company that you are getting the insurance from, and the kind of health insurance that you are opting to go in for. There are a number of plans that are usually offered to customers, and it is essential to know what these plans entail.

Family Insurance
Under the Affordable Care Act, insurance companies in twenty-three states in the United States are required to pay for the patient's weight loss surgery as part of the insurance coverage that they have opted to go in for. As a result, a person who is in possession of some individual or family insurance can go in for the weight loss surgery without having to worry about the expenses not being covered by their provider. Typically, when one is trying to get weight loss surgery, the hospital or clinic is the one who will contact the insurance company about the procedure recommended by your doctor, and after that, they let you know if your operation is covered by insurance. You can also contact the insurance company themselves to know whether or not the plan that you have is covering weight loss surgeries.

Employer-Funded Insurance
If the company that you are working with offers you some kind of health coverage, and you are within the twenty-three states, there is a high chance that you will be given the coverage for the surgery that you want to go in for. The process for this is similar to what we mentioned for family insurance, which is that either the clinic will contact your insurance provider, or you can do so yourself.

When it comes to employer-provided insurance, however, certain professional institutions may have additional restrictions when it comes to the kind of policy they offer. One of the best ways to be sure of this is to contact an HR personnel within the company that you are working with to understand whether or not you can get the surgery that you need. Smaller companies are less likely to cover weight loss surgeries as compared to larger companies, which is also something that must be taken into consideration when relying on the insurance offered by your workplace.

​References:
https://www.fairhealthconsumer.org/insurance-basics/healthcare
http://www.baybariatrics.com/procedures/sleeve-gastrectomy
https://www.horizonblue.com/providers/news/news-legal-notices/prior-authorization-procedure-search-tool-available