Will My Insurance Cover Weight Loss Surgery?

When it comes to health insurance, one of the most common questions people have is whether or not their insurance plan will cover weight loss surgery. The answer isn’t always easy because there are many factors that can affect what’s covered and how much you pay in out-of-pocket costs. To help you understand your options, we’ve created this blog post. We’ll discuss what criteria need to be met for coverage, what the out-of-pocket costs are, and if getting bariatric surgery in Mexico might save money!

Do American Insurance Companies Pay for Weight Loss Surgery?

According to the Affordable Care Act, any plan offered on the open exchange must cover bariatric surgery. However, there are still some insurance companies that do not cover bariatric surgery because they are sold off the open exchange.

If you did not purchase your insurance through this exchange, speak to your provider to find out if they offer coverage. Also, keep in mind that even if they will pay for bariatric surgery, insurance companies require you to meet specific criteria before they will pay and often do not cover costs in full.

What Criteria Do I Need to Meet for Coverage?

The criteria that insurance companies use to determine if weight loss surgery is covered can vary greatly. However, most plans require that you meet certain health conditions, such as being morbidly obese (a body mass index of 40 or higher) or a BMI of 30-39 while having other obesity-related health problems like type II diabetes or high blood pressure. Some plans also require that you have tried other methods of weight loss unsuccessfully before they will consider covering surgery.

How Much Will I Have to Pay Out-of-Pocket?

Unfortunately, most insurance companies do not cover the entire cost of bariatric surgery. In fact, you may have to pay thousands of dollars in out-of-pocket costs in order to get the procedure you need. This can include co-pays, deductibles, and coinsurance payments.

Can Getting Weight Loss Surgery in Mexico Save Me Money?

One option that some people consider is getting weight loss surgery done in Mexico. The cost savings could be significant. For example, a gastric sleeve procedure in Mexico might only cost $5,000 compared to $20,000 in the United States. And for this price, you get everything you need for your procedure, including transportation to and from the airport or land crossing and your hotel and food.

If you are worried about getting the surgery you need covered by your insurance or cannot afford the out-of-pocket costs, contact Hospital BC to learn about weight loss surgery in Mexico.