Verify Insurance Coverage
Your insurance coverage paves the way for your weight loss journey. With the help of an authorization specialist, our clinical teams will guide you every step of the way. However, we encourage you to be as prepared as possible with all insurance-related matters. Below is a helpful list of topics and resources to consider.
Insurance Coverage Considerations
Bariatric surgery coverage varies by health insurance policy, but there are several considerations to take into account regardless of your provider. To qualify for any weight loss procedure, you must be at least 18 years old and have a Body Mass Index (BMI) of 35 or higher. If your BMI is less than 40, you must suffer from a major, weight-related health issue to qualify for surgery. If your BMI is more than 40, you do not need to suffer from a weight-related health issue to qualify.
Most insurance plans also require a physician-supervised weight loss trial and a copy of one office visit note for each of the last 3 to 5 years listing your weight, to demonstrate your obesity has been a long-term health issue. Your provider will have more details.
Check with your insurance to see if CPT (Current Procedural Terminology) codes 43775 gastric sleeve and/or 43644 gastric bypass are covered.