How to Get Obesity Surgery Covered When It Is Not Covered By a Plan

Obesity surgery, or bariatric surgery, offers different methods to artificially shrink the size of the stomach. This naturally limits the number of calories that can be consumed throughout the day, aiding weight loss efforts. Although there are countless overweight individuals who can benefit from this type of treatment, insurance companies often have specific restrictions on who is eligible for coverage. Where bariatric surgery is not covered by your specific plan, there are a number of steps you can take to potentially get it covered.

Instructions

• 1

  Apply for Medicare to cover the cost of bariatric surgery when it is not covered by your plan. The general standards for Medicare coverage are thus: you should be 65 or older; or, in the alternative, under the age of 65 with certain disabilities (with morbid obesity being considered a disability in many cases). Contact your local social services agency to determine whether you qualify.

• 2

  Change insurance companies to obtain a policy with more liberal qualifying standards for the coverage of bariatric surgery. Different insurance companies will have differing standards for treatment, so call around to other companies in your area and consult with an agent to determine whether you would qualify under their plan. While the pre-existing conditions clause in the contract would normally preclude you from claiming coverage for a condition existing at the time of the contract signing (for a period of 12 months or so), the pre-existing conditions clause will not apply where you are moving from one plan to another.

• 3

  Consult with local bariatric surgeons about the possibility of reducing the cost of treatment in whole or in part through pro bono work. Many surgeons will perform a certain number of pro bono cases throughout the year, depending on the particular need. If you have a troubling story of weight control problems with a looming risk of various obesity-related medical conditions, you might be able to find a surgeon willing to perform the operation for a fraction of the original cost.