What health care insurance covers lap band or gastric bypass surgery? Depends. Health care insurance covering the lap band surgical procedure is determined on a person-by-person basis. Some policies only cover the procedure when/if medically necessary. It may be covered if you meet the national guidelines for the care of morbid obesity.
Insurance Companies that cover Lap Band
These are companies that are known to partially cover or completely cover LAP Band surgery. It does not guarantee that you will be covered. Insurance companies cover surgery on a case-by-case basis.
- Blue Cross (some states)
- One Health
- Tufts Health Plan
- American Family Insurance
- Great West
- First Health
- Anthem BCBS
To determine if you insurance policy covers bariatric ( lap band ) surgery, refer to the insurance policy packet you would have received after paying your first premium. For group coverage, it would have been provided by your employer. If you don’t have a copy, contact your human resources department or your insurance provider. They will be able to provide a copy for you.
Most likely there are two sections that describe limits and the extent of your coverage. Look for:
- Covered Expenses or What is covered (or similar) – This lists all the healthcare benefits for which the insurance company will pay.
- What is not covered” or “When the plan does not pay benefits”. - cost that may not be covered by your plan
Look for statements where the health insurance company excludes coverage for weith control, treatment for obesity, surgery for weith control, or exclude outright bariatric surgeries.
Look closely for statements such as “Surgery for the treatment of obesity is covered when deemed medically necessary”. If bariatric or lap band surgery is excluded except when medically necessary, then if you meet the carriers guidelines, you may qualify.