Gastric sleeve and health insurance: How to get approved

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There are several options for weight loss surgery. One newer procedure that’s growing in popularity is the sleeve gastrectomy (or gastric sleeve).

In a gastric sleeve procedure, the majority of the stomach is removed. The procedure, technically simpler than a gastric bypass, does not involve rearranging the gastrointestinal anatomy, but it does require surgical staplers. The procedure is irreversible.

Since this is a newer procedure, it is less likely that your insurance company will cover it. So you may be wondering how to get approved for gastric sleeve.

Insurance: How to get approved for a gastric sleeve

The first thing to remember is that approval for gastric sleeve surgery depends on what your insurance company requires. However, in our experience, insurance companies typically require the following:

  • Your body mass index (or BMI) is the ratio of your body weight to height. It’s arrived at via a simple BMI calculation that divides your weight (kg) by your height (m) squared. Insurers typically require a BMI over 35 with at least one comorbidity.
  • Physical Therapy, Nutrition and Psychology evaluations.
  • Some insurance requires patients to be drug- and smoke-free for six months, and will verify compliance with blood tests.
  • Patients may also be required to follow a weight management plan, which may last anywhere from three months to one year, and to keep regular appointments with dietitians and psychologists.
  • Some plans also require documentation of past attempts at weight loss.

It might be helpful to ask your insurance agent if your policy covers morbid obesity.

Oregon Weight Loss Surgery

Whew! That’s a lot to remember. But don’t worry — Oregon Weight Loss Surgery is here to help. We even offer a free benefits check to see if you’re covered for a gastric sleeve.

Contact Oregon Weight Loss Surgery for details and to see if you’re a candidate for weight loss surgery.

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