Insurance Information
Many insurance plans cover weight loss surgery when medical necessity is established. Our insurance team will help you navigate the approval process from start to finish.
Insurance Coverage for Bariatric Surgery
Weight loss surgery is recognized as a medically necessary treatment for severe obesity by most major insurance companies. Coverage typically requires meeting specific criteria, including BMI thresholds, documentation of obesity-related health conditions, and evidence of previous medically supervised weight loss attempts.
At MISH Hospital, our dedicated insurance specialists work directly with your insurance provider to determine your benefits, obtain pre-authorization, and manage the approval process. We understand the complexities of insurance requirements and are committed to making this process as straightforward as possible for you.
Common Insurance Requirements
While requirements vary by plan, most insurance companies require the following for bariatric surgery coverage:
- BMI of 40 or higher, or BMI of 35 to 39.9 with one or more qualifying comorbidities
- Documentation of obesity for a specified period (typically five years)
- Record of medically supervised weight loss attempts (often three to six months)
- Completion of pre-operative evaluations including medical, nutritional, and psychological assessments
- Letter of medical necessity from your physician
- Pre-authorization from your insurance company
Some plans may have additional requirements or different criteria. Our insurance team will review your specific plan and guide you through each step of the process.
Self-Pay and Financing Options
For patients whose insurance does not cover bariatric surgery, or who prefer not to use insurance, MISH Hospital offers competitive self-pay pricing and financing options. We believe that cost should not be a barrier to receiving life-changing treatment. Contact our office to discuss self-pay rates and available payment plans.