Medicare and Weight Loss Surgery: What Should You Know?

Medicare and Weight Loss Surgery: What Should You Know?

Diagram of medicare

For many people who have Medicare and weight loss surgery needs, there is help. This type of procedure is designed to help you to lose weight quickly. Because it is so effective at helping people to drop the pounds, many doctors encourage it. However, the out of pocket costs for a procedure like this can be significant. As a result, many people do not have it because they fear the costs associated with it. Yet, you may have coverage if you have Medicare.

What Are the Medicare and Weight Loss Surgery Qualifications?

In order to have your procedure, you may need to ensure you meet the qualifications of Medicare and weight loss surgery in general. Medicare requires that you have a BMI of over 35 to qualify for this procedure. The BMI is a number that takes into account your body’s height and weight. It is a representation of the percentage of body fat you have. The lower this number is, the better. Those who have a BMI of over 30 generally qualify for weight loss surgery, but for the Medicare and weight loss surgery, you will need to be at or above 35.

Other Qualifications for Medicare and Weight Loss Surgery

In addition to the BMI factor, most of the time individuals will also need at least one type of weight-related health problem. For example, you may have type 2 diabetes, heart disease, sleep apnea, or high blood pressure to qualify. The thought is that if you lose the weight, these conditions could improve for you, improving your health.

What Else Do You Have to Do?

You will also have to have documented evidence of your attempts of losing weight and your inability to do so. This must be documented by your doctor. You will need to be in a medically supervised weight loss program that uses counseling, exercise, and diet to help you to lose weight. You will also need to have a psychological evaluation to ensure you are healthy enough for surgery. You will need to use an approved center as well.

The fact is that when it comes to Medicare and weight loss surgery, it is still viewed as a last resort. If you have done the work to lose weight and have failed at it, then you may qualify for this type of surgery and receive some coverage. Keep in mind that there will be out of pocket costs, which range significantly from one patient to the next.

 

 

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