In Texas, many insurance plans cover bariatric surgery, also known as weight loss surgery. Bariatric surgery is typically covered by private insurance plans, as well as Medicaid and Medicare.
Private insurance plans: Many private insurance plans, including those offered by employers, cover bariatric surgery for people who meet certain medical criteria, such as a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with one or more obesity-related comorbidities, such as type 2 diabetes or high blood pressure. It is important to note that the specific requirements for coverage may vary depending on the individual’s insurance plan.
Medicaid: Medicaid, which is a state and federal program that provides healthcare coverage for low-income individuals and families, covers bariatric surgery for people who meet certain medical criteria, such as a BMI of 40 or higher or a BMI of 35 or higher with obesity-related comorbidities. The specific requirements for coverage may vary depending on the individual’s Medicaid plan.
Medicare: Medicare, which is a federal program that provides healthcare coverage for people over the age of 65 and some younger people with disabilities, covers bariatric surgery for people who meet certain medical criteria, such as a BMI of 35 or higher with obesity-related comorbidities or a BMI of 30 or higher with severe obesity-related comorbidities. The specific requirements for coverage may vary depending on the individual’s Medicare plan.
It is important to note that these are general guidelines and the specific requirements for coverage of bariatric surgery may vary depending on the individual’s insurance plan and location. It is recommended to contact the insurance provider directly or to speak with a healthcare provider to get a better understanding of the specific requirements for coverage of bariatric surgery.
