Does Medicare Cover Bariatric Surgery?
Medicare covers bariatric surgery if it is considered medically necessary by a doctor.
If Medicare does pay for your bariatric surgery, you'll typically face out-of-pocket Medicare costs that can add up quickly.
A Medicare Supplement (Medigap) plan can help cover bariatric surgery costs, such as Medicare copays, coinsurance, deductibles and more.
What Is Bariatric Surgery?
Bariatric surgery includes gastric bypass surgery and laparoscopic banding surgery, both of which help reduce the size of the stomach.
Some types of bariatric surgeries covered by Medicare include:
Lap band or realize band surgery
Morbid obesity is a severe problem that affects thousands of seniors in the United States every year.
Over 93 million adults in the U.S. are obese, which is almost 40% of adults.
41% of adults age 60 and older are obese.1
When Will Medicare Cover Lap Band Surgery?
Medicare may cover your bariatric surgery if you have:
A BMI (body mass index) of 35 or higher
At least one obesity-related illness
Records proving obesity for five years or more
Proof of participation and failure in more than one supervised weight loss program
A letter from your physician recommending bariatric surgery
A record of a psychological evaluation with a passing grade
Proof that all other diseases are not the cause of obesity. This includes documentation of completed adrenal, pituitary, or thyroid screening tests.
Medigap Can Help You Pay for Bariatric Surgery
Even if Medicare covers your bariatric surgery, there are some out-of-pocket costs that you should be prepared to pay, including deductibles, copayments and coinsurance.
Medicare Supplement Insurance helps cover some of your Medicare out-of-pocket bariatric surgery costs.
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
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1 State of Obesity 2022: Better Policies for a Healthier America. Trust for America’s Health.
Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.