Bariatric Surgery Insurance: Complete Patient Guide

Bariatric surgery insurance is provided by most insurance companies in the United States, but whether or not you're covered will depend on your specific policy. This page includes...

Bariatric Surgery Insurance Coverage by Plan Type & State

Before searching for your insurance company's specific coverage requirements for weight loss surgery, you need to know whether your specific policy covers it. Review the following depending on your plan type to find out...

Obamacare Weight Loss Surgery States (for Individual, Family & Small Group Plans)

  • Arizona
  • California
  • Delaware
  • Hawaii
  • Illinois
  • Iowa
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Oklahoma
  • Rhode Island
  • South Dakota
  • Vermont
  • West Virginia
  • Wyoming

Individual or Family Bariatric Surgery Coverage

Due to the passage of the Affordable Care Act (Obamacare), insurance companies in 23 states are REQUIRED to cover weight loss surgery for all Individual Plans, Family Plans and Small Group Plans (employers with fewer than 50 full-time employees). See the adjacent box for an updated list of Affordable Care Act weight loss surgery states.

To confirm your coverage, you have a couple of options:

  • Option 1 (recommended): Your local surgeon will contact your insurance company to confirm your benefits for free (even if you don't move forward with surgery). Their office will be very familiar with your insurance company's requirements and approval process, so it's usually a good idea to let them do the leg work for you. Click here to find a local surgeon.
  • Option 2: Contact your insurance company yourself and/or check your Summary Plan Description (SPD). Click here for the full list of United States insurance companies, contact information and bariatric surgery coverage requirements.

If you find out that weight loss surgery is not covered, you still have several options for financing bariatric surgery to make treatment more affordable and to potentially reduce your out of pocket expenses.

For more information about Bariatric Surgery and the Affordable Care Act, see our Obamacare Weight Loss Surgery Page.

Back to top of SECTION: of Bariatric Surgery Insurance Coverage by Plan Type & State

Small Group Bariatric Surgery Insurance Coverage (2 to 50 full-time employees)

Weight loss surgery insurance coverage guidelines for Small Group (50 or fewer full time employees) are the same as for Individual/Family Plans. Click here to jump up to that section.

To confirm your Small Group bariatric surgery insurance coverage, you have a three options:

  • Option 1 (recommended): Your local surgeon will contact your insurance company to determine your coverage details for no charge (even if you decide not to have surgery). Their office has been through the approval process with your insurance company many times, so let them work on your behalf to make the process go as smoothly as possible. Click here to find a local surgeon.
  • Option 2: Ask your Human Resources (HR) Department whether or not weight loss surgery is an included benefit under your plan.
  • Option 3: Contact your insurance company yourself and/or check your Summary Plan Description (SPD). Click here for the full list of United States insurance companies, contact information and bariatric surgery coverage criteria.

If you have short term disability insurance through your employer, also see our section on Disability Insurance. You may be able to receive portion of your monthly salary while you’re having and recovering from surgery.

Back to top of SECTION: of Bariatric Surgery Insurance Coverage by Plan Type & State

Large Group Weight Loss Surgery Insurance Coverage (51+ full-time employees)

If you get your insurance through your work and your employer has 51 or more full time employees, it is completely up to your company to decide whether or not to cover weight loss surgery.

To confirm your coverage, you have a three options:

  • Option 1 (recommended): Your local surgeon will contact your insurance company to confirm your benefits for free. Their office will be very familiar with your insurance company's requirements and approval process, so it's usually a good idea to let them do the leg work for you. Click here to find a local surgeon.
  • Option 2: Ask your Human Resources (HR) Department whether or not weight loss surgery is an included benefit under your plan.
  • Option 3: Contact your insurance company yourself and/or check your Summary Plan Description (SPD). Click here for the full list of United States insurance companies, contact information and bariatric surgery coverage policy details.
  • If you find out that bariatric surgery insurance is NOT included under your plan, you may want to head over to our Weight Loss Surgery Insurance Secrets page to learn how you may be able to get your company to add the coverage.

    If you have short term disability insurance through your employer, you may be able to receive portion of your monthly salary while you’re having and recovering from surgery. See our Short Term Disability section for more information.

Back to top of SECTION: of Bariatric Surgery Insurance Coverage by Plan Type & State

Medicare & Medicaid Bariatric Surgery Insurance Coverage

Medicare and Medicaid BOTH cover bariatric surgery as long as you meet their qualification guidelines:

Medicaid Coverage & Bariatric Surgeons

Many surgeons do not accept Medicaid due to lower reimbursement levels (they are unable to cover their costs with the lower fees that Medicaid is allowed to pay).

Contact your local surgeon to confirm whether or not they will accept your Medicaid insurance. If they don't, ask for a referral to a surgeon who does.

  1. A body mass index (BMI) over 35
  2. At least one co-morbidity (health problem) related to obesity
  3. Must have documentation in your medical records confirming that previous attempts at medical treatment for obesity have been unsuccessful

If you meet each of the above criteria, Medicare and Medicaid will cover the following procedures:

To get approved, you’ll need to be referred by your primary care physician or other attending doctor (probably not just a self-referral to a bariatric surgeon). Your surgeon will also need to be in The Centers for Medicare and Medicaid Services (CMS) directory.

If you have Medicare Advantage, you'll need to verify that your chosen surgical team and their hospital are in your insurance company's network. Contact your insurance company directly to find out (click here for a full list of insurance companies and contact info).

See our Medicaid/Medicare Bariatric Surgery page for more information.

Back to top of SECTION: of Bariatric Surgery Insurance Coverage by Plan Type & State
Back to top of PAGE: of Bariatric Surgery Insurance: Complete Guide

Bariatric Surgery Coverage Requirements:
A to Z Insurance Companies

The table below lists ALL health insurance companies in the United States that we know about along with the following:

  • Link to local surgeon directory: Most surgeons will contact your insurance company for you for free to confirm your bariatric surgery insurance coverage (they'll usually do this regardless of whether you've decided to move forward with surgery). Their office will likely be very experienced in dealing with the complicated nuances of getting surgery approved by your insurance company, so we highly recommend working through them instead of trying to figure things out on your own. Click here to contact a local surgeon to get the process started.
  • Link to weight loss surgery insurance coverage policy: the presence (or lack of) a link to your insurance company's policy does NOT confirm whether or not you have coverage. To figure out if your plan includes bariatric surgery insurance, see the Coverage by Plan Type and State section above.
  • Link to insurance company contact info: We've found your insurance company's contact info for you so you don't have to go digging for it.

Click the letter that your insurance company's name begins with or use the table's scroll bar on the right...

Insurance Company Find Local Surgeon (Will Check Insurance for Free) Bariatric Surgery Insurance Coverage Policy Insurance Company Contact Info
A - Bariatric Surgery Insurance Coverage Criteria by Company
1199SEIU Ask Local Surgeon to Check Your 1199SEIU Benefits for Free n/aContact 1199SEIU Directly
Aetna Ask Local Surgeon to Check Your Aetna Benefits for Free Aetna Weight Loss Surgery Coverage CriteriaContact Aetna Directly
Altius Ask Local Surgeon to Check Your Altius Benefits for Free n/aContact Altius Directly
American Medical Security Ask Local Surgeon to Check Your American Medical Security Benefits for Free n/aContact American Medical Security Directly
AmeriHealth Ask Local Surgeon to Check Your AmeriHealth Benefits for Free AmeriHealth Weight Loss Surgery Coverage CriteriaContact AmeriHealth Directly
Anthem Blue Cross and/or Blue Shield Ask Local Surgeon to Check Your Anthem BCBS Benefits for Free Anthem Blue Cross Blue Shield Weight Loss Surgery Coverage CriteriaContact Anthem BCBS Directly
Arches Health Plan Ask Local Surgeon to Check Your Arches Health Plan Benefits for Free n/aContact Arches Health Plan Directly
Arise Health Plan Ask Local Surgeon to Check Your Arise Health Plan Benefits for Free n/aContact Arise Health Plan Directly
Asuris Northwest Health Ask Local Surgeon to Check Your Asuris Northwest Health Benefits for Free Asuris Northwest Health Weight Loss Surgery Coverage CriteriaContact Asuris Northwest Health Directly
B - Bariatric Surgery Insurance Coverage Criteria by Company
Blue Cross and/or Blue Shield (Kansas City) Ask Local Surgeon to Check Your Blue Cross and Blue Shield (Kansas City) Benefits for Free Blue Cross and Blue Shield (Kansas City) Weight Loss Surgery Coverage CriteriaContact Blue Cross and Blue Shield (Kansas City) Directly
Blue Cross and/or Blue Shield (Alabama) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Alabama) Benefits for Free Blue Cross and/or Blue Shield (Alabama) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Alabama) Directly
Blue Cross and/or Blue Shield (Arizona) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Arizona) Benefits for Free Blue Cross and/or Blue Shield (Arizona) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Arizona) Directly
Blue Cross and/or Blue Shield (Arkansas) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Arkansas) Benefits for Free Blue Cross and/or Blue Shield (Arkansas) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Arkansas) Directly
Blue Cross and/or Blue Shield (California) Ask Local Surgeon to Check Your Blue Shield (California) Benefits for Free Blue Shield (California) Weight Loss Surgery Coverage CriteriaContact Blue Shield (California) Directly
Blue Cross and/or Blue Shield (Florida) Ask Local Surgeon to Check Your Blue Cross Blue Shield (Florida) Benefits for Free Blue Cross Blue Shield Florida Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Florida) Directly
Blue Cross and/or Blue Shield (Georgia) Ask Local Surgeon to Check Your Blue Cross Blue Shield (Georgia) Benefits for Free Blue Cross Blue Shield Georgia Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Georgia) Directly
Blue Cross and/or Blue Shield (Hawaii) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Hawaii) Benefits for Free Blue Cross and/or Blue Shield (Hawaii) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Hawaii) Directly
Blue Cross and/or Blue Shield (Idaho) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Idaho) Benefits for Free Blue Cross and/or Blue Shield (Idaho) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Idaho) Directly
Blue Cross and/or Blue Shield (Illinois) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Illinois) Benefits for Free Blue Cross and/or Blue Shield (Illinois) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Illinois) Directly
Blue Cross and/or Blue Shield (Kansas City) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Kansas City) Benefits for Free Blue Cross and/or Blue Shield (Kansas City) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Kansas City) Directly
Blue Cross and/or Blue Shield (Kansas) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Kansas) Benefits for Free Blue Cross and/or Blue Shield (Kansas) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Kansas) Directly
Blue Cross and/or Blue Shield (Louisiana HMO) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Louisiana HMO) Benefits for Free n/aContact Blue Cross and/or Blue Shield (Louisiana HMO) Directly
Blue Cross and/or Blue Shield (Louisiana NON-HMO) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Louisiana) Benefits for Free Blue Cross and/or Blue Shield (Louisiana) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Louisiana) Directly
Blue Cross and/or Blue Shield (Massachusetts) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Massachusetts) Benefits for Free Blue Cross and/or Blue Shield (Massachusetts) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Massachusetts) Directly
Blue Cross and/or Blue Shield (Michigan) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Michigan) Benefits for Free Blue Cross and/or Blue Shield (Michigan) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Michigan) Directly
Blue Cross and/or Blue Shield (Minnesota) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Minnesota) Benefits for Free Blue Cross and/or Blue Shield (Minnesota) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Minnesota) Directly
Blue Cross and/or Blue Shield (Mississippi) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Mississippi) Benefits for Free Blue Cross and/or Blue Shield (Mississippi) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Mississippi) Directly
Blue Cross and/or Blue Shield (Montana) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Montana) Benefits for Free Blue Cross and/or Blue Shield (Montana) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Montana) Directly
Blue Cross and/or Blue Shield (Nebraska) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Nebraska) Benefits for Free Blue Cross and/or Blue Shield (Nebraska) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Nebraska) Directly
Blue Cross and/or Blue Shield (New Mexico) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (New Mexico) Benefits for Free Blue Cross and/or Blue Shield (New Mexico) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (New Mexico) Directly
Blue Cross and/or Blue Shield (New York - Northeastern) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (New York - Northeastern) Benefits for Free Blue Cross and/or Blue Shield (New York - Northeastern) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (New York - Northeastern) Directly
Blue Cross and/or Blue Shield (New York - Western) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (New York - Western) Benefits for Free Blue Cross and/or Blue Shield (New York - Western) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (New York - Western) Directly
Blue Cross and/or Blue Shield (North Carolina) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (North Carolina) Benefits for Free Blue Cross and/or Blue Shield (North Carolina) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (North Carolina) Directly
Blue Cross and/or Blue Shield (North Dakota) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (North Dakota) Benefits for Free Blue Cross and/or Blue Shield (North Dakota) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (North Dakota) Directly
Blue Cross and/or Blue Shield (Oklahoma) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Oklahoma) Benefits for Free Blue Cross and/or Blue Shield (Oklahoma) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Oklahoma) Directly
Blue Cross and/or Blue Shield (Pennsylvania-Northeastern - Wilkes-Barre_ Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Pennsylvania-Northeastern - Wilkes-Barre_ Benefits for Free Blue Cross and/or Blue Shield (Pennsylvania-Northeastern - Wilkes-Barre_ Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Pennsylvania-Northeastern - Wilkes-Barre_ Directly
Blue Cross and/or Blue Shield (Rhode Island) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Rhode Island) Benefits for Free Blue Cross and/or Blue Shield (Rhode Island) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Rhode Island) Directly
Blue Cross and/or Blue Shield (South Carolina) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (South Carolina) Benefits for Free Blue Cross and/or Blue Shield (South Carolina) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (South Carolina) Directly
Blue Cross and/or Blue Shield (Tennessee) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Tennessee) Benefits for Free Blue Cross and/or Blue Shield (Tennessee) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Tennessee) Directly
Blue Cross and/or Blue Shield (Texas) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Texas) Benefits for Free Blue Cross and/or Blue Shield (Texas) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Texas) Directly
Blue Cross and/or Blue Shield (Vermont) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Vermont) Benefits for Free Blue Cross and/or Blue Shield (Vermont) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Vermont) Directly
Blue Cross and/or Blue Shield (Wyoming) Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield (Wyoming) Benefits for Free Blue Cross and/or Blue Shield (Wyoming) Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield (Wyoming) Directly
Blue Cross and/or Blue Shield Federal Employee Plan Ask Local Surgeon to Check Your Blue Cross and/or Blue Shield Federal Employee Plan Benefits for Free Blue Cross and/or Blue Shield Federal Employee Plan Weight Loss Surgery Coverage CriteriaContact Blue Cross and/or Blue Shield Federal Employee Plan Directly
BridgeSpan Health Ask Local Surgeon to Check Your BridgeSpan Health Benefits for Free BridgeSpan Health Weight Loss Surgery Coverage CriteriaContact BridgeSpan Health Directly
C - Bariatric Surgery Insurance Coverage Criteria by Company
Capital BlueCross - Harrisburg Ask Local Surgeon to Check Your Capital BlueCross - Harrisburg Benefits for Free Capital BlueCross - Harrisburg Weight Loss Surgery Coverage CriteriaContact Capital BlueCross - Harrisburg Directly
CareFirst Blue Cross Blue Shield Ask Local Surgeon to Check Your CareFirst Blue Cross Blue Shield Benefits for Free CareFirst Blue Cross Blue Shield Weight Loss Surgery Coverage CriteriaContact CareFirst Blue Cross Blue Shield Directly
CHAMPVA Ask Local Surgeon to Check Your CHAMPVA Benefits for Free CHAMPVA Weight Loss Surgery Coverage CriteriaContact CHAMPVA Directly
Cigna Ask Local Surgeon to Check Your Cigna Benefits for Free Cigna Weight Loss Surgery Coverage CriteriaContact Cigna Directly
ConnectiCare Ask Local Surgeon to Check Your ConnectiCare Benefits for Free ConnectiCare Weight Loss Surgery Coverage CriteriaContact ConnectiCare Directly
CoOportunity Health Ask Local Surgeon to Check Your CoOportunity Health Benefits for Free CoOportunity Health Weight Loss Surgery Coverage CriteriaContact CoOportunity Health Directly
Coventry Health Care Ask Local Surgeon to Check Your Coventry Health Care Benefits for Free n/aContact Coventry Health Care Directly
CoventryOne Ask Local Surgeon to Check Your CoventryOne Benefits for Free n/aContact CoventryOne Directly
D - Bariatric Surgery Insurance Coverage Criteria by Company
Dean Health Ask Local Surgeon to Check Your Dean Health Benefits for Free Dean Health Weight Loss Surgery Coverage CriteriaContact Dean Health Directly
E - Bariatric Surgery Insurance Coverage Criteria by Company
Definity Health Ask Local Surgeon to Check Your Definity Health Benefits for Free n/aContact Definity Health Directly
Emblem Health Ask Local Surgeon to Check Your Emblem Health Benefits for Free Emblem Health Weight Loss Surgery Coverage CriteriaContact Emblem Health Directly
Empire Blue Cross and Blue Shield Ask Local Surgeon to Check Your Empire Blue Cross and Blue Shield Benefits for Free Empire Blue Cross and Blue Shield Weight Loss Surgery Coverage CriteriaContact Empire Blue Cross and Blue Shield Directly
Excellus BlueCross BlueShield Ask Local Surgeon to Check Your Excellus BlueCross BlueShield Benefits for Free Excellus BlueCross BlueShield Weight Loss Surgery Coverage CriteriaContact Excellus BlueCross BlueShield Directly
F - Bariatric Surgery Insurance Coverage Criteria by Company
Fallon Health Ask Local Surgeon to Check Your Fallon Health Benefits for Free Fallon Health Weight Loss Surgery Coverage CriteriaContact Fallon Health Directly
First Health Ask Local Surgeon to Check Your First Health Benefits for Free n/aContact First Health Directly
G - Bariatric Surgery Insurance Coverage Criteria by Company
Geisinger Health Plan Ask Local Surgeon to Check Your Geisinger Health Plan Benefits for Free Geisinger Health Plan Weight Loss Surgery Coverage CriteriaContact Geisinger Health Plan Directly
Golden Rule Ask Local Surgeon to Check Your Golden Rule Benefits for Free Golden Rule Weight Loss Surgery Coverage CriteriaContact Golden Rule Directly
Group Health Ask Local Surgeon to Check Your Group Health Benefits for Free Group Health Weight Loss Surgery Coverage CriteriaContact Group Health Directly
H - Bariatric Surgery Insurance Coverage Criteria by Company
HAP (Health Alliance Plan) Ask Local Surgeon to Check Your HAP (Health Alliance Plan) Benefits for Free n/aContact HAP (Health Alliance Plan) Directly
HCSC Ask Local Surgeon to Check Your HCSC Benefits for Free HCSC Weight Loss Surgery Coverage CriteriaContact HCSC Directly
Health Net Ask Local Surgeon to Check Your Health Net Benefits for Free Health Net Weight Loss Surgery Coverage CriteriaContact Health Net Directly
Health Plan of Nevada Ask Local Surgeon to Check Your Health Plan of Nevada Benefits for Free Health Plan of Nevada Weight Loss Surgery Coverage CriteriaContact Health Plan of Nevada Directly
Health Republic Insurance of New Jersey Ask Local Surgeon to Check Your Health Republic Insurance of New Jersey Benefits for Free Health Republic Insurance of New Jersey Weight Loss Surgery Coverage CriteriaContact Health Republic Insurance of New Jersey Directly
HealthAmerica Ask Local Surgeon to Check Your HealthAmerica Benefits for Free n/aContact HealthAmerica Directly
HealthPartners Ask Local Surgeon to Check Your HealthPartners Benefits for Free HealthPartners Weight Loss Surgery Coverage CriteriaContact HealthPartners Directly
HealthPlus Ask Local Surgeon to Check Your HealthPlus Benefits for Free HealthPlus Weight Loss Surgery Coverage CriteriaContact HealthPlus Directly
HealthSpan Ask Local Surgeon to Check Your HealthSpan Benefits for Free n/aContact HealthSpan Directly
Highmark Blue Cross and/or Blue Shield Ask Local Surgeon to Check Your Highmark Blue Cross Blue Shield Benefits for Free Highmark Blue Cross Blue Shield Weight Loss Surgery Coverage CriteriaContact Highmark Blue Cross Blue Shield Directly
HIP Health Plan of New York Ask Local Surgeon to Check Your HIP Health Plan of New York Benefits for Free HIP Health Plan of New York Weight Loss Surgery Coverage CriteriaContact HIP Health Plan of New York Directly
HMSA (Hawaii Medical Service Association) Ask Local Surgeon to Check Your HMSA (Hawaii Medical Service Association) Benefits for Free HMSA (Hawaii Medical Service Association) Weight Loss Surgery Coverage CriteriaContact HMSA (Hawaii Medical Service Association) Directly
Horizon Blue Cross and Blue Shield Ask Local Surgeon to Check Your Horizon Blue Cross and Blue Shield Benefits for Free Horizon Blue Cross and Blue Shield Weight Loss Surgery Coverage CriteriaContact Horizon Blue Cross and Blue Shield Directly
Humana Ask Local Surgeon to Check Your Humana Benefits for Free Humana Weight Loss Surgery Coverage CriteriaContact Humana Directly
I - Bariatric Surgery Insurance Coverage Criteria by Company
Independence Blue Cross - Philadelphia Ask Local Surgeon to Check Your Independence Blue Cross - Philadelphia Benefits for Free Independence Blue Cross - Philadelphia Weight Loss Surgery Coverage CriteriaContact Independence Blue Cross - Philadelphia Directly
Innovation Health Ask Local Surgeon to Check Your Innovation Health Benefits for Free Innovation Health Weight Loss Surgery Coverage CriteriaContact Innovation Health Directly
K - Bariatric Surgery Insurance Coverage Criteria by Company
Kaiser Ask Local Surgeon to Check Your Kaiser Benefits for Free Kaiser Weight Loss Surgery Coverage CriteriaContact Kaiser Directly
L - Bariatric Surgery Insurance Coverage Criteria by Company
LifeWise Health Plan of Oregon Ask Local Surgeon to Check Your LifeWise Health Plan of Oregon Benefits for Free LifeWise Health Plan of Oregon Weight Loss Surgery Coverage CriteriaContact LifeWise Health Plan of Oregon Directly
LifeWise Health Plan of Washington Ask Local Surgeon to Check Your LifeWise Health Plan of Washington Benefits for Free LifeWise Health Plan of Washington Weight Loss Surgery Coverage CriteriaContact LifeWise Health Plan of Washington Directly
M - Bariatric Surgery Insurance Coverage Criteria by Company
Medica Ask Local Surgeon to Check Your Medica Benefits for Free Medica Weight Loss Surgery Coverage CriteriaContact Medica Directly
Medicare / Medicaid Ask Local Surgeon to Check Your Medicare or Medicaid Benefits for Free Medicare/Medicaid Weight Loss Surgery Coverage Requirements Contact the Centers for Medicare and Medicaid Services Directly
Medical Mutual of Ohio Ask Local Surgeon to Check Your Medical Mutual of Ohio Benefits for Free Medical Mutual of Ohio Weight Loss Surgery Coverage CriteriaContact Medical Mutual of Ohio Directly
Meritus Ask Local Surgeon to Check Your Meritus Benefits for Free Meritus Weight Loss Surgery Coverage CriteriaContact Meritus Directly
Moda Health Ask Local Surgeon to Check Your Moda Health Benefits for Free Moda Health Weight Loss Surgery Coverage CriteriaContact Moda Health Directly
MVP Health Care Ask Local Surgeon to Check Your MVP Health Care Benefits for Free MVP Health Care Weight Loss Surgery Coverage CriteriaContact MVP Health Care Directly
My Health Alliance Ask Local Surgeon to Check Your My Health Alliance Benefits for Free My Health Alliance Weight Loss Surgery Coverage CriteriaContact My Health Alliance Directly
N - Bariatric Surgery Insurance Coverage Criteria by Company
New Mexico Health Connections Ask Local Surgeon to Check Your New Mexico Health Connections Benefits for Free n/aContact New Mexico Health Connections Directly
O - Bariatric Surgery Insurance Coverage Criteria by Company
Office of Group Benefits (OGB) PPO Ask Local Surgeon to Check Your Office of Group Benefits (OGB) PPO Benefits for Free n/aContact Office of Group Benefits (OGB) PPO Directly
Optima Health Ask Local Surgeon to Check Your Optima Health Benefits for Free Optima Health Weight Loss Surgery Coverage CriteriaContact Optima Health Directly
Oscar Ask Local Surgeon to Check Your Oscar Benefits for Free n/aContact Oscar Directly
Oxford Health Ask Local Surgeon to Check Your Oxford Health Benefits for Free Oxford Health Weight Loss Surgery Coverage CriteriaContact Oxford Health Directly
P - Bariatric Surgery Insurance Coverage Criteria by Company
PacificSource Health Plans Ask Local Surgeon to Check Your PacificSource Health Plans Benefits for Free n/aContact PacificSource Health Plans Directly
Physicians Health Plan (PHP) Ask Local Surgeon to Check Your Physicians Health Plan (PHP) Benefits for Free n/aContact Physicians Health Plan (PHP) Directly
Physicians Plus Ask Local Surgeon to Check Your Physicians Plus Benefits for Free Physicians Plus Weight Loss Surgery Coverage CriteriaContact Physicians Plus Directly
PreferredOne Ask Local Surgeon to Check Your PreferredOne Benefits for Free PreferredOne Weight Loss Surgery Coverage CriteriaContact PreferredOne Directly
Premera Blue Cross and/or Blue Shield Ask Local Surgeon to Check Your Premera Blue Cross Blue Shield Benefits for Free Premera Blue Cross Blue Shield Weight Loss Surgery Coverage CriteriaContact Premera Blue Cross Blue Shield Directly
Presbyterian Ask Local Surgeon to Check Your Presbyterian Benefits for Free Presbyterian Weight Loss Surgery Coverage CriteriaContact Presbyterian Directly
Prevea360 Health Plan Ask Local Surgeon to Check Your Prevea360 Health Plan Benefits for Free n/aContact Prevea360 Health Plan Directly
PriorityHealth Ask Local Surgeon to Check Your PriorityHealth Benefits for Free PriorityHealth Weight Loss Surgery Coverage CriteriaContact PriorityHealth Directly
Providence Health Plan Ask Local Surgeon to Check Your Providence Health Plan Benefits for Free Providence Health Plan Weight Loss Surgery Coverage CriteriaContact Providence Health Plan Directly
Q - Bariatric Surgery Insurance Coverage Criteria by Company
QualChoice - Federal Employees Health Benefits Ask Local Surgeon to Check Your QualChoice - Federal Employees Health Benefits Benefits for Free QualChoice - Federal Employees Health Benefits Weight Loss Surgery Coverage CriteriaContact QualChoice - Federal Employees Health Benefits Directly
QualChoice - White County Medical Center Ask Local Surgeon to Check Your QualChoice - White County Medical Center Benefits for Free QualChoice - White County Medical Center Weight Loss Surgery Coverage CriteriaContact QualChoice - White County Medical Center Directly
R - Bariatric Surgery Insurance Coverage Criteria by Company
Regence BlueCross and/or BlueShield Ask Local Surgeon to Check Your Regence BlueCross BlueShield of Oregon Benefits for Free Regence BlueCross and/or BlueShield Weight Loss Surgery Coverage CriteriaContact Regence BlueCross BlueShield of Oregon Directly
Rocky Mountain Health Plans Ask Local Surgeon to Check Your Rocky Mountain Health Plans Benefits for Free Rocky Mountain Health Plans Weight Loss Surgery Coverage CriteriaContact Rocky Mountain Health Plans Directly
S - Bariatric Surgery Insurance Coverage Criteria by Company
Scott & White Health Plan Ask Local Surgeon to Check Your Scott & White Health Plan Benefits for Free Scott & White Health Plan Weight Loss Surgery Coverage CriteriaContact Scott & White Health Plan Directly
Security Health Plan Ask Local Surgeon to Check Your Security Health Plan Benefits for Free n/aContact Security Health Plan Directly
SelectHealth Ask Local Surgeon to Check Your SelectHealth Benefits for Free n/aContact SelectHealth Directly
Sierra Health and Life Ask Local Surgeon to Check Your Sierra Health and Life Benefits for Free Sierra Health and Life Weight Loss Surgery Coverage CriteriaContact Sierra Health and Life Directly
SummaCare Ask Local Surgeon to Check Your SummaCare Benefits for Free n/aContact SummaCare Directly
T - Bariatric Surgery Insurance Coverage Criteria by Company
TennCare Ask Local Surgeon to Check Your TennCare Benefits for Free n/aContact TennCare Directly
TriCare Ask Local Surgeon to Check Your TriCare Benefits for Free TriCare Weight Loss Surgery Coverage CriteriaContact TriCare Directly
Tufts Health Plan Ask Local Surgeon to Check Your Tufts Health Plan Benefits for Free Tufts Health Plan Weight Loss Surgery Coverage CriteriaContact Tufts Health Plan Directly
U - Bariatric Surgery Insurance Coverage Criteria by Company
Unicare Ask Local Surgeon to Check Your Unicare Benefits for Free Unicare Weight Loss Surgery Coverage CriteriaContact Unicare Directly
UnitedHealthOne Ask Local Surgeon to Check Your UnitedHealthOne Benefits for Free UnitedHealthOne Weight Loss Surgery Coverage CriteriaContact UnitedHealthOne Directly
United Healthcare Ask Local Surgeon to Check Your United Healthcare Benefits for Free United Healthcare Weight Loss Surgery Coverage CriteriaContact United Healthcare Directly
W - Bariatric Surgery Insurance Coverage Criteria by Company
Wellmark Blue Cross and Blue Shield Ask Local Surgeon to Check Your Wellmark Blue Cross and Blue Shield Benefits for Free Wellmark Blue Cross and Blue Shield Weight Loss Surgery Coverage CriteriaContact Wellmark Blue Cross and Blue Shield Directly
WINhealth Ask Local Surgeon to Check Your WINhealth Benefits for Free WINhealth Weight Loss Surgery Coverage CriteriaContact WINhealth Directly
WPS Health Insurance Ask Local Surgeon to Check Your WPS Health Insurance Benefits for Free n/aContact WPS Health Insurance Directly

Can’t find your insurance company/plan or have an updated link? Click here to contact us.

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Bariatric Surgery Insurance Coverage by Procedure

Most health plans that provide bariatric surgery insurance will pay for the following procedures (assuming you meet their coverage criteria):

Some also cover the following in certain circumstances:

Most insurance companies will NOT cover procedures OTHER THAN those listed above (e.g. experimental weight loss surgery procedures).

Click here to compare all types of bariatric surgery.

The Typical Weight Loss Surgery Insurance Approval Process

If your plan includes bariatric surgery insurance, you will need to meet all of your insurance company's coverage criteria (click here for list of insurance companies) to confirm the "medical necessity" of your surgery.

Assuming you follow all the guidelines and provide complete, accurate information requested by your insurance company, the process from start to finish can take anywhere from one month to one year.

To prove to your insurance company that your surgery is medically necessary, following are the typical steps:

  1. Minimum body mass index (BMI) requirements to be confirmed by your physician:
    • BMI over 40 --OR--
    • BMI over 35 with one or more of the following:
      • Clinically significant obstructive sleep apnea
      • Coronary heart disease
      • Medically refractory hypertension
      • Type 2 diabetes mellitus
  2. Complete a medically supervised diet program. Bariatric surgery insurance criteria for the length of the program range from 3 to 7 consecutive months.
  3. Schedule a consultation with your bariatric surgeon.
  4. Schedule a consultation with your primary care physician to obtain a medical clearance letter.
  5. Schedule a psychiatric evaluation to obtain a mental health clearance letter.
  6. Schedule a nutritional evaluation from a Registered Dietitian.
  7. Send all of the above documentation to your insurance company along with a detailed history of your obesity-related health problems, difficulties and treatment attempts. The review process typically happens in under one month.
  8. Insurance company sends approval or denial letter:
    • If approved, your surgeon's bariatric coordinator will contact you for scheduling.
    • If denied, you can choose to appeal the denial.

Your surgeon's office will be very experienced in managing the above process and may have all of the required personnel on staff (e.g. registered dietitian, psychiatrist, bariatric coordinator, etc.).

Click here to access the weight loss surgeon directory to get started. Most offices will check your insurance for free to confirm coverage criteria.

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Bariatric Surgery Insurance References

  1. Vanek VW. State laws on insurance coverage for bariatric surgery: help or a hindrance? American Society for Bariatric Surgery. May 2005. doi:10.1016/j.soard.2005.05.001.

[Last editorial review/modification of this page: 8/20/2014]

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