Does Aetna Cover Weight Loss Surgery

Losing weight can be a challenge. However, if you are experiencing obesity or have been struggling with overweight issues, you might have considered weight loss surgery. It is essential to consult your healthcare provider and insurance provider to ensure that you are covered for the procedure. In this article, we will discuss if Aetna covers weight loss surgery or not.

According to our research, Aetna does cover weight loss surgery, although the coverage depends on factors such as your healthcare provider, the state you reside in, and the type of weight loss surgery you need. The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends the following procedures as beneficial for weight loss surgery:

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1. Roux-en-Y gastric bypass surgery
2. Laparoscopic adjustable gastric banding
3. Sleeve gastrectomy
4. Biliopancreatic diversion with duodenal switch

If you are considering weight loss surgery and have Aetna insurance, the following procedures may be covered:

• Gastric bypass
• Gastric sleeve
• LAP-BAND
• Duodenal switch

However, Medicare and Medicaid do not usually cover weight loss surgery unless there are exceptional circumstances or medical requirements. If you do not have a medical reason for the procedure, your insurance may not cover weight loss surgery.

It is essential to note that Aetna often requires that you meet specific requirements before they approve the procedure. These requirements include having a Body Mass Index (BMI) of over 40, or a BMI of over 35 with a related medical condition such as sleep apnea, hypertension, or diabetes.

If you meet all the requirements for Aetna’s coverage, the next step is to find a qualified healthcare provider who will be responsible for your surgery. You should schedule an appointment with your primary care provider or ask for a referral from your insurance provider.

After you have found a healthcare provider, they will evaluate your medical history to determine if you qualify for weight loss surgery. If you qualify, your healthcare provider will work closely with you to develop a weight loss plan that fits your needs and body.

Overall, Aetna covers weight loss surgery, but there are specific requirements that you must meet before they approve the procedure. Make sure that you consult with your healthcare provider and insurance provider if you are considering weight loss surgery. They will help you navigate the process and ensure that you choose the best option for your needs.

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