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Insurance companies differ in their requirements for approval of weight loss surgery. Furthermore, any given insurance company may have different requirements depending on the individual policy the patient has. For example, Blue Cross Blue Shield may have different requirements from one policy to another. The general guidelines used come from National Institute of Health criteria for weight loss surgery:

  • BMI > 40
  • BMI 35 or greater with existing medical conditions that are the result of obesity.
  • Patients must have demonstrated that previous attempts of weight loss have failed.
  • Age must be older than 18.

Most insurance companies require evaluation by a psychiatrist or psychologist prior to approval. Some insurance companies may require evaluation by a dietician or nutritionist as well. Your surgeon will determine whether you need further medical evaluation by medical specialists such as a Cardiologist, etc. All patients are required to attend an informational seminar, followed by a consultation with the surgeon.

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