April 5, 2021

Health Insurance Bariatric Surgery Cover USA 2021

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What Health Insurance Covers Bariatric Surgery

Health Insurance Bariatric Surgery Cover USA 2021 – According to the WHO guidelines, an adult with more than 30 BMI is considered to be morbidly obese. Bariatric surgery is an operation that offers a solution for people who want to lose weight. Americans are one of the societies that are getting heavier. According to the Centers for Disease Control and Prevention, adult obesity has doubled over the past 30 years. At least 20% of adults in each of the states in America are obese. Read more about Health Insurance Bariatric Surgery Cover USA 2021.

In order to cater to the Health Insurance Bariatric Surgery Cover USA 2021, issue, many have turned towards bariatric surgery combined with a change in diet to lose weight.

Health Insurance Bariatric Surgery Cover USA 2021 – Risks and benefits of bariatric surgery

According to The American Society for Metabolic & Bariatric Surgery (ASMBS), the mortality rate for bariatric surgery after almost 30 days is about 0.1%, or you can say one in 1000 people. ASMBS also states that the mortality rate recorded for this surgery has a mortality rate that is relevantly lower than the others.

While the risks might seem a bit scary, the benefits totally outweigh them. It increases the life expectancy of the individual up to 89% after surgery. It directly affects blood pressure, asthma, sleep apnea, arthritis, breathing disorders, fatty liver disease, gastroesophageal reflux disease, cholesterol abnormalities, fatty liver disease, and many more, which eventually solves obesity-related problems.

This surgery operates on the stomach and only makes you eligible for it if:

  • You have been unsuccessful in losing weight even after changing your diet and exercising.
  • Possess a BMI of 40 or more
  • Have a BMI between 35-40 together with weight-related problems such as diabetes or high blood pressure

Does health insurance cover bariatric surgery?

A surgery that costs between $17000 to $26000 requires most individuals to require insurance coverage. Fortunately, health insurance does cover bariatric surgery, considering you have met the requirements. As every insurer doesn’t cover the cost, you must check on your policy’s terms before scheduling the surgery. Let’s look at three major health insurance companies’ information regarding obesity surgery:


When it comes to Health Insurance Bariatric Surgery Cover USA 2021,  individual health insurance, Aetna doesn’t offer a sole health plan covering bariatric surgery. Most of the Aetna groups HMO and POS, exclude coverage for the surgery until approved by Aetna. For Aetna, plans that cover bariatric surgery requires the following for gastric bypass approval:

  • BMI of 40 or more
  • BMI of 35 or more with coronary heart disease, Type 2 diabetes, sleep apnea, or refractory hypertension

The criteria also require you to:

  • Have attempted to lose weight in the past but remained unsuccessful.
  • Have taken part in an exercise or nutrition program.


Cigna offers affordable health insurance that covers bariatric surgery. Most of the customers in employer-sponsored plans have availed this coverage. Almost all of the Cigna plans cover obesity screening, behavioral counseling, and nutritional screening and counseling. After becoming eligible to avail of the coverage, you have to meet medical necessity. Some of the plans present the option of dollar maximum while the others don’t. The State mandates and Affordable Care Act rules affect the implications of dollar maximum.

To be able to avail of the coverage, the individual has to meet the following criteria:

  • Be of 18 years of age or more.
  • Having a BMI above 40 or more for the past 24 months or a BMI or 35-39.9 for at least 24 months in the past. The individual should also have at least one obesity-related issue like pulmonary hypertension or Type 2 diabetes.
  • Participation in the last two years in a weight-management program.
  • An examination within the last 12 months, including a surgeon who is qualified enough to perform bariatric surgery recommending the treatment, a separate medical evaluation recommending the surgery, clearance by a mental health provider, and nutritional evaluation by a physician or certified dietitian.

Signa also covers any reversals in case of complications.

Medica health insurance

Medica offers affordable health insurance for bariatric surgery if they meet the following criteria

  • Are of 18 years or more
  • BMI of more than 40 or BMI index of 35-39.9 with one of the obesity-related comorbidities like hypertension, sleep apnea, type 2 diabetes, coronary artery disease, or significant gastroesophageal reflux disease (GERD).
  • Participation in an exercise or nutrition counseling regimen

Conclusion – Health Insurance Bariatric Surgery Cover USA 2021

According to the US Health Care, around 179 million individuals registered for health insurance in 2019. Now we all know how important it is to have insurance in this unpredictable world. Besides, we can never be sure what we might face in the next second. So why not plan our future more safely – for everyone that matters to us, especially our parents. In their old age, we are most responsible for their safety and health.

That’s when it’s our turn to show care and attention to our parents, and so, choosing the right insurance company and getting one for our parents can be a smart way to fulfill our responsibility towards them. But what if you can put your parents on your insurance? In this way, you don’t have to choose any cheap health insurance for your parents to secure their future. Yet, is it possible? Let’s go ahead and explore more on who can be added as a dependent in your insurance.

It would be best if you made sure that your specific health insurance plan includes the surgery in it for you to avail yourself it. Make sure to complete all the documentation to avoid a denial. So this concludes the topic for Health Insurance Bariatric Surgery Cover USA 2021.