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Does Medicare or Medicaid pay for bariatric surgery?

Author

Andrew Vasquez

Updated on March 09, 2026

Does Medicare or Medicaid pay for bariatric surgery?

Medicare covers some bariatric surgical procedures, like gastric bypass surgery and laparoscopic banding surgery, when you meet certain conditions related to morbid obesity.

Accordingly, does Medicaid cover obesity treatment?

Medicaid and CHIP can cover a range of services to prevent and reduce obesity including Body Mass Index (BMI) screening, education and counseling on nutrition and physical activity, prescription drugs that promote weight loss, and, as appropriate, bariatric surgery.

Additionally, does Medicare pay for lap band surgery? Medicare's Criteria For Weight Loss Surgery Coverage. Medicare covers weight loss surgery in most cases assuming you meet the coverage requirements. Not every weight loss procedure is covered either. If the criteria are met, Medicare covers Gastric Bypass, Lap Bands and Gastric Sleeve surgeries.

Also question is, do I qualify for weightloss surgery?

Morbid obesity is defined as a BMI score of 40 or more. You typically qualify for bariatric surgery if you have a BMI of 35-39, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure. A BMI of 40 or higher also is a qualifying factor.

How much does bariatric surgery cost with Medicare?

Although gastric bypass surgery averages around $15,000, most Medicare beneficiaries only pay standard plan costs.

How can I get a free gastric sleeve?

Free Weight Loss Surgery Grant

Surgery Grants help people who are unable to afford gastric bypass get the funding for all or part of bariatric surgery. There is a Free Weight Loss Surgery Grant Now Available for gastric bypass through the Weight Loss Surgery Foundation of America (WLFSA).

Will Medicare pay for skin removal after weight loss surgery?

Medicare will pay for abdominoplasty (or a tummy tuck) after weight loss surgery if it is deemed medically necessary due to excess skin that causes rashes or infections.

How can I get my insurance to pay for weight loss surgery?

You and your doctor need to get pre-approval for weight-loss surgery. Similar to other insurers, Medicare will likely require a BMI of at least 35, your weight must also be causing serious health issues and you've attempted for years to lose weight through diet and exercise.

What is the safest weight loss surgery?

Sleeve gastrectomy surgery

The benefits: Dr. Aminian says the sleeve is a bit safer than gastric bypass: The risk of all complications is 3% after sleeve vs. 5% with Roux-en-Y gastric bypass.

What insurance pays for bariatric surgery?

Many PPO insurance providers are now providing coverage for Gastric Sleeve, Gastric Bypass, Distal Bypass and Lap-Band Removal. Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare and United Health Care typically cover weight loss procedures.

Is 70 too old for weight loss surgery?

Conclusion: Bariatric surgery in carefully screened patients aged >70 years can be performed safely and can achieve modest improvement in co-morbidities.

What weight loss surgery is covered by Medicare?

Weight loss surgery is no different, the Item Numbers are Gastric Bypass - 31572, Sleeve Gastrectomy - 31575. This means that Medicare will partially cover the costs involved in your surgery.

How can I lose weight fast?

Here are 9 more tips to lose weight faster:
  1. Eat a high protein breakfast.
  2. Avoid sugary drinks and fruit juice.
  3. Drink water before meals.
  4. Choose weight-loss-friendly foods.
  5. Eat soluble fiber.
  6. Drink coffee or tea.
  7. Base your diet on whole foods.
  8. Eat slowly.

Does insurance pay for weight loss programs?

Key takeaways: Obesity screening and counseling is covered with no out-of-pocket costs in most health plans under the Affordable Care Act. Coverage for weight-loss medication among people with private insurance is uneven, but you can work with your doctor to increase your chances.

Does Aetna cover weight loss surgery?

Aetna covers most weight loss surgeries. However, you should note that most Aetna HMO and QPOS plans exclude coverage of surgical operations for the treatment of obesity unless approved by Aetna. Make sure you contact Aetna directly to find out if you policy includes weight loss surgery coverage.

How much is the sleeve surgery?

“The surgery for a sleeve gastrectomy is about $17,500 and for bypass it's about $27,000.” The good news: the price hurdle is often one that patients can overcome on their way to healthier lifestyles because more and more, insurers are willing to cover the surgeries — especially when employers demand coverage.

Does Medicaid cover Xenical?

If you have coverage through Medicaid, or have dual eligibility, meaning you have coverage through Medicaid and Medicare together, you may have coverage for Xenical. Medicaid only covers these drugs for treatment of hypertension and not as a weight loss aid.

How much is bariatric surgery out of pocket?

The cost of weight-loss surgery depends on a number of factors, including your location, the hospital, the surgeon's fees, and the type of procedure. According to Obesity Coverage, a bariatric surgery information site, the average cost of lap-band surgery is $14,500, while gastric bypass costs an average of $23,000.

What states require bariatric insurance coverage?

All states but Colorado, District of Columbia, Florida, Idaho, Louisiana, Nebraska, Tennessee, Utah, and Washington cover all or some forms of bariatric surgery. Nutritional counseling and therapy is now a required health benefit in 16 states.

How much is BMI?

Height: Weight: Your BMI is , indicating your weight is in the category for adults of your height. For your height, a normal weight range would be from to pounds.

Adult BMI Calculator.

BMIWeight Status
Below 18.5Underweight
18.5—24.9Normal
25.0—29.9Overweight
30.0 and AboveObese

Does United Healthcare Medicaid cover weight loss surgery?

For eligible members, weight loss surgery may be covered when medically necessary.

What's the minimum weight for gastric bypass?

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

What is dump syndrome?

Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. The condition can also develop in people who have had esophageal surgery.

How long does it take to get approved for weight loss surgery?

How long does it take for a person to get approved for weight loss surgery? It takes about three months for a person to get approved for weight loss surgery, from the first visit to the doctor until the person is medically cleared.

How do I get approved for weight loss surgery?

To be eligible for weight-loss surgery, you must meet the following requirements: Have a body mass index (BMI) of 40 or higher, or have a BMI between 35 and 40 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea.

Can a 12 year old get weight loss surgery?

Teens can be considered for weight loss surgery if: They have a body mass index (BMI) of 35 or more with serious medical problems caused by weight, like diabetes, heart disease, liver disease, or sleep. They have a BMI of 40 or more, or are 100 or more pounds over their ideal body weight.

What is the least invasive weight loss surgery?

“Endoscopic weight loss procedures are a great option between medication and surgery,” says Kumbhari. “They work better than medication, but are less invasive than surgery and carry fewer side effects and risks.”

How much weight do you need to lose before weight loss surgery?

Amount of pre-surgery weight loss

Some patients are required to lose 10 percent of their weight before weight-loss surgery is performed. For other patients, losing just 15 to 20 pounds right before surgery is enough to reduce the risk of complications.

Do I qualify for lapband surgery?

you have a body mass index (BMI) of 40 or more, or a BMI between 35 and 40 and an obesity-related condition that might improve if you lost weight (such as type 2 diabetes or high blood pressure) you've tried all other weight loss methods, such as dieting and exercise, but have struggled to lose weight or keep it off.

How painful is gastric bypass surgery?

You may feel pain at your incision site or from the position your body was in during surgery. Some patients also experience neck and shoulder pain after laparoscopic bariatric surgery. Your comfort is very important to us.

What is Medicare covered dental?

Dental services

Medicare doesn't cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you're in a hospital.

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