Does insurance pay for weight loss surgery?

Yes, most private insurance companies will cover all or most of the cost of weight loss surgery, which is also known as bariatric surgery. This is because obesity can lead to many long-term health complications, such as diabetes and cardiovascular disease, which can be expensive to treat.
People without insurance or insurance that does not cover bariatric surgery may have to pay for the surgery in full. Some weight loss surgery centers can help arrange a loan to cover the procedure. A person can pay off the loan over a set number of months.
Insurance plans vary, but most have criteria a person must meet before they will pay toward weight loss surgery. Criteria may include:
a body mass index (BMI) of 40 or more
body mass index (BMI)
40 or more
a BMI of 35 with one or more obesity-related conditions, such as: type 2 diabetescardiovascular diseasehigh blood pressure or hypertensionsleep apnea
type 2 diabetes
type 2 diabetes
cardiovascular disease
cardiovascular disease
high blood pressure or hypertension
high blood pressure or hypertension
sleep apnea
sleep apnea
a BMI of 30 or more with type 2 diabetes that is difficult to manage with lifestyle changes and medical treatments
Most insurance companies require a letter from a person’s primary doctor that says weight loss surgery is medically necessary. The letter should include the following information:
the person’s height, weight history, and BMI
details of the person’s obesity-related conditions, including treatment
medications the person currently takes
reasons for surgery, including the effects on the person’s quality of life
a detailed history of past weight loss efforts, such as participation in a weight loss program
details of preoperative education that addresses the risks and benefits of surgery, realistic expectations of surgery outcomes, and the need for follow-up visits and behavioral modifications
nutritional counseling with a registered dietitian
preoperative medical and mental health clearances following evaluations
Requirements of private insurers vary, so it is important to talk with them directly. They may cover the surgery in full or only part of it, meaning the person has to pay the remaining cost.
Weight loss surgery may cost $15,000 to $25,000 or more, depending on the type of surgery and whether there are complications. Surgery in urban areas may be more expensive than in less densely populated areas, as costs are higher and surgeons are in greater demand.
$15,000 to $25,000
The cost of surgery typically includes:
the surgeon’s fee
anesthesia
anesthesia
the stay in the hospital
Many people also require further surgeries, such as body contouring and excess skin removal. There may also be costs for diet and fitness plans and behavioral modification therapy.
Sometimes, insurers do not agree to pay for weight loss surgery. This may be due to:
weight loss surgery
inadequate evidence that a person meets their criteria
a lack of coverage for weight loss surgery, which may be due to an employer not purchasing that coverage
In these instances, people can appeal to their insurance company, with the help of their primary doctor, or ask their employer to purchase weight loss coverage from their insurer. The Obesity Action Coalition provides a fact sheet explaining the benefits of bariatric surgery that may be useful when making an appeal.
Obesity Action Coalition
Learn about Medicare’s coverage of weight loss surgery.
Medicare’s coverage of weight loss surgery