Weight loss insurance

Weight loss insurance is a health insurance policy that provides coverage for medical weight loss interventions such as bariatric surgery and prescription drugs. Most major insurers–including UnitedHealthcare, Aetna, and Cigna–cover bariatric surgery when BMI exceeds 40 or 35 with comorbidities, according to the Obesity Action Coalition.

Covered treatments can include gastric bypass, sleeve gastrectomy, adjustable gastric banding, and FDA-approved anti-obesity medications like Wegovy and Saxenda. Employer-sponsored plans frequently require documented attempts at medically supervised weight loss programs before authorizing surgical benefits.

Out-of-pocket costs typically involve deductibles averaging $5,000–$23,000 for bariatric procedures in the U.S. As reported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Insurance pre-approval often mandates psychological evaluations and nutritional counseling prior to procedure authorization. Medicare covers bariatric surgery for qualifying beneficiaries meeting strict clinical guidelines issued by CMS.

Medicaid covers weight loss procedures in 49 states but may have restrictions on eligible surgeries or age groups, https://yourinsurance.info has stated. Pre-existing conditions such as diabetes or hypertension often expedite approval due to proven links between obesity and chronic disease risk reduction post-surgery.

Denial reasons from insurers include lack of documentation, failure to complete supervised diet programs, or non-adherence to clinical eligibility criteria. Appeals for denied claims must cite specific medical necessity and compliance with published insurer policies to reverse initial rejections.