Does Medi Cal Cover Weight Loss Surgery?

Many Medi Cal plans in California offer a program called MediCal Plus. This plan offers benefits that are similar to Medicare and Medicaid, but costs that are less than those programs. However, MediCal Plus is a supplement to Medicare and Medicaid and not a stand-alone program. Here are some of the questions you might have about MediCal Plus and whether or not it is a good option for your MediCal policy.

Does MediCal cover weight loss surgery? As with Medicare and Medicaid, MediCal does offer coverage for surgical procedures. However, it is usually not a good idea to select a weight loss procedure from MediCal if you are not a serious obese person. Most weight loss surgeries carry a significant cost and a portion of the cost may be tied into MediCal benefits. If you need a gastric bypass or liposuction, speak to a representative of your health insurance company to learn more about other options for weight loss surgery in the California area.

Is there an age limit for MediCal? Unlike Medicare or Medicaid, MediCal does not require an age limit. However, you should be aware that the cost of weight loss surgery can increase sharply as a person's body size increases. You should talk with your doctor to determine if you are a candidate for weight loss surgery under the care and supervision of a qualified physician.

Can I choose my own physician? Only some physicians are available through MediCal, so you cannot choose your physician. However, if you can find a doctor who accepts MediCal payments, it is possible for you to save money by having your surgery performed by this physician. Again, discuss this with your physician to determine if this option is a good one for you.

What is my anticipated recuperation time? Most weight-loss surgery requires recovery time. In most cases, you will return to work within a few days to a week. Speak with your health insurance provider to find out what the normal recovery time from surgery is for your type of procedure. You will also want to find out if there are any restrictions on your diet or exercise program while you heal.

Does MediCal cover the cost of overseas procedures? Unfortunately, overseas surgeries are usually quite expensive, but if your doctor offers a particularly unique type of treatment in a foreign country, it may be worth your while to take advantage of this coverage. You should check with your insurance provider and find out exactly what is covered as well as the policy that you will need to bring abroad.

How do I pay for my weight loss surgery in California? Most MediCal programs offer surgery financing options, which allow you to make payments on the surgery itself and any associated procedures directly through your health care provider. You will likely have to provide your credit card information for this type of payment, but the payments are usually far more affordable than they would be for surgery at a hospital. If you find yourself needing to make multiple payments for other medical expenses, you may want to talk with your health insurance provider about a payment plan that can help you make the multiple payments easier to fit into your budget.

Once you understand the answers to these questions, you will know what is not covered by MediCal. Keep in mind that the terms and conditions regarding weight loss surgery in California vary from one insurance provider to the next, so it's best to speak with a representative from each company to get the right information about MediCal coverage. This knowledge will give you peace of mind when you go to get the procedure, allowing you to focus on your recovery.