Does UnitedHealthcare Cover Gastric Sleeve Surgery?

Many of the patients who come to us at West Medical to have a bariatric procedure are considering using their UnitedHealthcare insurance to cover their gastric sleeve surgery. One of their main concerns is often whether they will meet the necessary requirements of their plan.

UnitedHealthCare coverage

West Medical is the premier weight loss surgery provider in southern California and we happily work with all PPO insurance plans to try and accommodate our patient's needs. Typically, as long as you meet your insurance plan’s conditions for your bariatric surgery you are eligible to have coverage.

Gastric sleeve surgery is also known as laparoscopic sleeve gastrectomy surgery and is frequently a preferred choice for patients. The reason many patients choose this method to assist with achieving their weight loss goal is they have exhausted alternative methods and not experienced the success they desire.

Gastric sleeve surgery is considered a safe and effective procedure to reduce appetite over time, making it far easier for patients to make dietary changes which can lead to successful long-term weight loss.

While you can review your UnitedHealthcare insurance policy package to see what weight control expenses are covered or excluded, you may find it easier to simply give us a call, or text us now at (855) 690-0565 now to verify your insurance details. One of our bariatric surgery insurance coordinators can verify your UnitedHealthcare policy has laparoscopic sleeve gastrectomy coverage for you.

There is absolutely no obligation to have us verify your laparoscopic sleeve gastrectomy coverage and if you don’t meet your insurance policy’s criteria, we can request an individual need assessment, or send a letter of medical necessity on your behalf. We can also help you through the appeal process if necessary.

UnitedHealthcare Laparoscopic Sleeve Gastrectomy Coverage

Just as each person is different, UnitedHealthcare’s gastric sleeve coverage and pre-approval criteria can be very different for each prospective patient. Prior to covering any laparoscopic sleeve gastrectomy surgery, UnitedHealthcare requires a patient to have a Body Mass Index (BMI) of 35 or greater. They must also have a written letter describing their weight history for the last 5 years including all attempted exercise programs, diets, and weight loss programs.

Patients also need to undergo a psychological evaluation and a nutritional evaluation before they can qualify for UnitedHealthcare’s gastric sleeve surgery coverage. If your BMI is below 40, United Healthcare will look at any weight-related medical conditions before authorizing any coverage for your surgery.

Do You Meet the UnitedHealthcare Insurance Requirements for Gastric Sleeve Surgery?

You may automatically pre-qualify for United Healthcare gastric sleeve surgery coverage if you meet the following criteria:

  • You are 100 pounds or more above the ideal weight, or

  • You have a Body Mass Index of 40 or greater, or

  • You have a Body Mass Index of 35 or greater and suffer from medical problems associated with obesity such as cardiovascular disease, mechanical arthropathy, lower extremity lymphatic or venous obstruction, hypertension, hyperlipidemia, type 2 diabetes, severe obstructive sleep apnea, coronary artery disease or pulmonary hypertension

  • You have been overweight for at least two years, and

  • You have failed all weight-loss attempts including diets, exercise and weight loss programs

How to Find Out More About UnitedHealthcare Gastric Sleeve Surgery Insurance Coverage

To see if your UnitedHealthcare insurance plan covers laparoscopic sleeve gastrectomy, please call or text us now at (855) 690-0565 to verify your insurance details. One of our expert team will be available to help you with any questions you may have.

UnitedHealthcare is an operating division of UnitedHealth Group, the largest single health carrier in the United States. UnitedHealthcare provides healthcare insurance coverage with a nationwide network that serves more than 26 million Americans[1] and partners with more than 1.3 million physicians[2] and care professionals, and 6,500 hospitals and other care facilities nationwide.

Disclaimer: This site is not affiliated with or endorsed by UnitedHealthcare and is for informational purposes only. The aforementioned UnitedHealthcare gastric sleeve surgery guidelines have been compiled from various public sources. It is presented online for informational use only, and without warranty as to its accuracy, timeliness, or completeness. This site does not replace any official versions of the information presented, nor does inclusion on this list guarantee coverage. Please check your UnitedHealthcare policy before proceeding with your surgery.

1 https://www.unitedhealthgroup.com/who-we-are/businesses/unitedhealthcare.html

2 https://www.uhc.com/about-us

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