Expert: Karla K. - 2/26/2008

Question
I can't find an insurance company that covers gastric bypass when medically necessary.  Do you know of any?  HELP!

Answer
Hi Sheryl:

Lots of insurance companies are covering bariatric surgery these days--even the Duodenal Switch.  Both Medicare and Medicaid do as well.  Unfortunately, though, if you are self-employed and seeking an individual policy, you may have more difficulty finding one.  Also, it's up to the individual company to decide whether or not they're going to include it in their policy.  You could petition your benefits administrator/HR department to cover the surgery, if that's the problem. There are some studies out there that shows that it makes sense financially long-term, especially if you suffer from a comorbidity like diabetes.

One thing that a few people have done is to take a job at a company that is known to cover WLS.  For example, Starbucks offers health insurance to part-time employees who work at least 20 hours/week.  Their insurance company and plan, Aetna, does cover bariatric surgery.

You can also go to www.obesityhelp.com . If you go to a surgeon you like, you'll find a list of insurance companies that have covered surgery with him.  Another option would be to just ask a surgeon you like which insurance companies have covered surgery with him or her.

Good luck!