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Asked: Apr 24, 2010

What insurance will cover Gastric Bypass Surgery ?

I don't have any health insurance right now and I want to have the gastric bypass surgery. What insurance company will pay for this? I am in Louisiana.

Categories: In California

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Answers

We receive this inquiry quite often from people all over the country. Apparently, finding an insurance company to cover this procedure is no easy task. We do not maintain a database of all of the covered benefits offered by the health insurance plans in various states, so we are not able to answer your question definitively. However, we can perhaps help you understand why you are running into problems finding an insurance company that will pay for gastric bypass surgery. Firstly, even if an insurance company does cover gastric bypass surgery, their representatives or plan brochures are not likely to say We cover gastric bypass surgery.' This is because there may be many variables that determine if they will cover this procedure. Primarily, it must be deemed 'medically necessary' for you to receive pre-authorization for treatment, if the benefit is offered at all. Most physicians will hesitate giving you this classification unless you have ehausted, or are unable, to use alternative methods to loose weight, such as diet and eercise. Secondly, in most states, including Louisiana, Individuals requires you to complete a health insurance application that will determine your eligibility. Part of this application includes questions to determine your health status, including your weight. Most insurance companies will not offer coverage to individuals that eceed a maimum weight for their height. The insurance companies consider obesity a greater immediate health risk than smoking and are concerned about the claims that will be submitted by persons in this classification. So, if your weight eceeds the maimum allowable by insurance companies, you may not be eligible for coverage even if you do find a health insurance company that covers gastric bypass surgery. If you have a group health plan available to you from an employer, or the employer of a spouse, this may be the best option for you to consider. Louisiana also has a high-risk health pool, but you would need to contact them about covering this benefit and any waiting periods.'

Answered: Apr 25, 2010

 

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