Most insurance providers cover bariatric surgery if you are morbidly obese, with a body mass index (BMI) greater than or equal to 40, or have a BMI greater than or equal to 35 and two or more serious obesity-related conditions such as:
Contact your insurance company for policy information on coverage, exclusions, deductibles, co-pay amounts and out-of-network benefits prior to scheduling surgery. Previous weight-loss attempts, physical condition, related illnesses, disabilities and their future impact are taken into consideration to determine medical necessity of the procedure.
The Temple Bariatric Surgery Program will assist you with the approval or pre-authorization process.
Before you undergo weight-loss surgery at Temple University Hospital or Jeanes Hospital, your insurance company will ask you to provide certain documentation to ensure you meet their coverage requirements. Your primary care doctor is your partner through this process, and can provide your insurance company with the required documentation. This may include monthly tracking records of your weight, your supervised weight-loss program and any counseling sessions.