What insurance plans in Texas cover bariatric surgery?

Bariatric surgery, also known as weight loss surgery, is a medical procedure that assists severely overweight or obese individuals in achieving substantial and sustained weight reduction. There are a number of insurance plans in Texas that cover bariatric surgery. While specific coverage and requirements may vary by insurance provider in Texas, the majority of plans cover this procedure in some capacity.

Blue Cross Blue Shield is one insurance plan in Texas that covers bariatric surgery. They provide coverage for gastric bypass, gastric sleeve, and laparoscopic adjustable gastric banding procedures. It is essential to note, however, that coverage may vary based on the particular policy and the individual’s medical condition. Before approving coverage for bariatric surgery, Blue Cross Blue Shield typically requires individuals to meet certain criteria, such as having a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions.

Aetna is another insurer in Texas that covers bariatric surgery. Aetna provides coverage for a variety of weight loss procedures, such as gastric bypass, gastric sleeve, and laparoscopic adjustable gastric banding. Aetna, like Blue Cross Blue Shield, has eligibility requirements that individuals must satisfy in order to be covered. These criteria may include evidence of unsuccessful weight loss attempts in the past, a BMI that exceeds a certain threshold, and documentation of obesity-related health conditions.

UnitedHealthcare is another Texas insurance provider that covers bariatric surgery. They encompass gastric bypass, gastric sleeve, and laparoscopic adjustable gastric banding. UnitedHealthcare, like other insurance providers, has eligibility requirements that individuals must satisfy to qualify for coverage. These requirements may include a BMI above a certain threshold, documentation of unsuccessful attempts to lose weight by other means, and a demonstrated commitment to making the necessary lifestyle changes after surgery.

Despite the fact that these insurance plans cover bariatric surgery, there may be additional out-of-pocket costs, such as deductibles, co-payments, and co-insurance. Additionally, the insurance provider may require pre-authorization before the surgery can be performed. Individuals contemplating bariatric surgery are advised to consult with their insurance provider and healthcare team to determine the specific coverage and requirements of their policy.

In conclusion, numerous insurance policies in Texas cover bariatric surgery. Blue Cross Blue Shield, Aetna, and UnitedHealthcare are a few examples of insurers that cover weight loss surgery. However, individuals must be aware of the specific coverage and requirements of their insurance plan, as well as any potential out-of-pocket expenses. Individuals can navigate the process of obtaining coverage for bariatric surgery by consulting with their insurance provider and healthcare team.