Does Medi Cal Cover Weight Loss Surgery?

If you are overweight, you might think about the benefits of weight loss surgery. For some people, however, this is not always an option. If you are also at risk for diabetes and heart disease, a surgery might be an attractive option, but weight loss surgery is not always covered by insurance. Medical plans do offer some coverage after your surgery. But if you are obese and are interested in using Medi Cal to help pay for your bypass surgery, you might be surprised to learn that you still have to pay for your procedure.

Even if your doctor has recommended a surgery as part of a weight loss strategy, you may have to pay for it out of pocket. Your insurance company will only pay the price of the surgery up to a prescribed amount based on your BMI. If you are extremely overweight or have high blood pressure or other health conditions, your insurer may not cover all or even most of the cost of your bypass surgery.

Because many insurers have specific guidelines about what they will and won't cover, you will have to call your insurance provider to find out what your policy says about weight loss surgery. This can be very frustrating and confusing. Many policies will say that you can use their plan in combination with their Medicare policy to lose weight. If that is the case, you'll have to learn how to use Medi Cal to achieve your weight loss goals.

Although Medicare does not cover everything, there are some items that are specifically excluded. You can lose weight through diet and exercise, but prescription medications and certain surgeries are not. Certain types of cancer treatments are also not covered. To find out if you are eligible for Medicare to help you lose weight, contact your insurance provider. If you are already on Medicare, you may be able to apply for additional Medicare insurance to finance your bypass surgery.

The Medical Insurance policy does not cover all of the expense of having the bypass surgery. In order to determine which procedures are excluded, your insurance provider will want to review your medical records. They will want to verify that you are in good health and that your health problems do not present a risk of your surgery. If any of your conditions is diagnosed as a pre-existing condition, the coverage may be limited.

Medical Insurance plans do not cover all of your surgery needs. It will depend on the extent of your obesity. For example, gastric bypass surgery is usually covered if you weigh 45 pounds or less. However, if you are overweight, you may need to get specialized treatment so your surgery will go well and you don't have to be put on a diet. On the other hand, Medical Plans do cover emergency weight loss surgery for many patients. Even if you are overweight, you may qualify for emergency surgery coverage if it is needed to treat a serious health condition like organ failure, or if you are suffering an acute trauma that could cause your death.

The Medical Insurance plan does offer a choice of surgeries to have your weight reduced. However, the majority of their programs have strict guidelines when it comes to weight loss surgery. The most common surgeries include gastric bypass, lap band, vertical banded gastroplication, Roux-en-Y gastric bypass and biliopancreatic diversion with hiatal hernia. These surgeries will all increase your BMI and your risk of serious health problems such as diabetes, hypertension, heart disease and stroke.

Medical Plans do offer some protection against prescription drug costs. In order to get approved for Medi Cal, you must meet a certain income requirement. Many Medical Plans also require proof of being a U.S. citizen or a legal resident. Although you may qualify for Medicare or Medicaid, and many people do, these programs do not cover the costs of weight loss surgery.