Most commercial (private or employer-provided) insurance plans approve all four typical weight loss surgical procedures — gastric bypass, vertical sleeve gastrectomy, gastric banding with LAP-BAND® or REALIZE® bands, or duodenal switch procedures — for the appropriate patients.
To receive approval, a patient usually needs to have a BMI (body mass index) above 40, or a BMI between 35 and 39 if the patient also has certain medical conditions such as diabetes, sleep apnea, or high blood pressure. Some insurance companies have a mandatory three-month weight management protocol that you must complete before surgery. Some have a protocol as long as six months.
For all plans, dietary and psychological evaluations are mandatory. This is a practical step that helps ensure your readiness for the procedure.
Your medical team can work with you to help you meet the particular requirements of your health plan in order to qualify for insurance coverage.