What is the Best Health Insurance for Weight Loss Surgery?

According to an American Heart Association study, obesity is a growing problem in the United States. It is linked to diseases such as high blood pressure and diabetes. A 2022 study found that obesity is linked to Type 2 diabetes in up to 53 percent of cases. With those who have chronic health issues, many are seeking alternatives such as weight loss surgery when traditional options such as diet and exercise are unsuccessful. We at CoverMile understand these concerns and have combed through the different insurance companies that offer bariatric surgery and have listed each below. Through our study, we hope to help you find the best health insurance for weight loss surgery.

Health Insurance Options for Weight Loss Surgery in Texas

Under the Affordable Care Act, 23 states have opted for insurance companies to require coverage for Bariatric Surgery. Texas is not one of them. However, in Texas, most insurance companies offer weight loss surgery coverage. You will find that insurance companies will vary which procedures they choose to provide. If this benefit is one you are contemplating, you should consider this when selecting your health insurance company.

Below we have researched four of the top weight loss surgery health insurance providers and list which procedures they cover, and at which age they begin their coverage.

Weight Loss Terms to Know

First, let’s give you a couple of terms you will come across often. Most of the time you will see them abbreviated. It is good to be familiar with them.

Body Mass Index (BMI)

Body Mass Index is an individual’s height in kilograms divided by the square of height in meters. If a body has a high BMI, it can indicate an increased body fatness. The body mass index checks for weight calories that lead to health issues, but it does not diagnose an individual’s health.

Class I, Class II, Class III

Most insurance companies separate their categories by class. Others separate them by definition. When it comes down to it, it is all the same. Here is how the classes are defined.

  • Class I is the lowest and is defined as a BMI of 30 – 34.9.
  • Class II is the middle rating and is defined as a BMI of 35 -39.9
  • Class III is the highest and is defined as a BMI greater than or equal to 40.

Now, let’s get into four of the top insurance companies that provide weight loss surgery in Texas.

Blue Cross Blue Shield

Blue Cross Blue Shield of Texas has two primary criteria needing to be met in order for subscribers to qualify for weight loss surgery.

  1. Morbid Obesity Diagnosis. This is further defined as one with:
  2. Body Mass Index (BMI) equal to or greater than 40.
  3. BMI equal to or greater than 35 with at least two of the following:
    1. Hypertension
    1. Dyslipidemia
    1. Type 2 Diabetes
    1. Sleep Apnea
  • Documentation from your surgeon that:
    • You are at least 18 years old and fully grown.
  • Professional evaluation within 12 months prior to surgery.

Most health insurance providers like BCBS of Texas cover many procedures for weight management. BCBS of Texas covers four weight loss procedures, and refrains from covering an additional four.

ProcedureCoveredNot Covered
Gastric BypassX 
Gastric BandingX 
Sleeve GastrectomyX 
Biliopancreatic BypassX 
Vertical Banded Gastroplasty X
Long Limb Gastric Bypass X
Mini-Gastric Bypass X


Candidates for weight loss insurance programs must qualify for Cigna health insurance that would cover weight loss surgery. This is broken down between adults and children:


For adults, the following must apply:

  1. Morbid Obesity Diagnosis.
  2. BMI equal to or more than 40.
  3. BMI equal to or greater than 35 with at least one of the following:
    1. Mechanical arthropathy in a weight-bearing joint.
    1. Diabetes mellitus
    1. Hypertension
    1. Hyperlipidemia
    1. Coronary artery disease
    1. Lower extremity lymphatic or venous obstruction
    1. Obstructive sleep apnea
    1. Pulmonary hypertension
    1. Fatty liver disease
  4. Multidisciplinary evaluation within the past 12 months that includes ALL the following:
    1. The proposed procedure description
    1. Medical management documentation and how it has failed.
    1. Health clearance for bariatric surgery by a mental health provider


Cigna covers several bariatric surgery procedures for both adults and adolescents. Some of which are not covered by other insurance providers.

ProcedureCovered AdultCovered Adolescent
Roux-en-Y Gastric BypassXX
Gastric Banding (LAP-Band)XNot covered
Sleeve GastrectomyXX
Biliopancreatic Diversion with Duodenal Switch (without Switch)XNot covered
Vertical Band GastroplastyXNot covered
Mini-Gastric BypassXNot covered
NOTESXNot covered


UnitedHealthcare covers bariatric procedures that are medically necessary. They must follow the following criteria:

  1. Class III obesity.
  2. BMI greater than or equal to 40 or 140% of the 95th percentile height, or
  3. Class II obesity with:
    1. Type 2 diabetes
    1. Cardiovascular disease
    1. History of coronary artery disease with surgery such as bypass or angioplasty

And the individual must meet the following criteria.

  • Both the following:
    • Evaluation including weight history with dietary and physical activity patterns.


  • Participate in a multidisciplinary surgical preparatory regimen.
ProcedureCovered AdultCovered Adolescent
Roux-en-Y Gastric BypassXX
Gastric Banding (LAP-Band)XX
Sleeve GastrectomyXX
Biliopancreatic Diversion with Duodenal Switch (without Switch)XX
Vertical Band GastroplastyXX
Mini-Gastric BypassNot coveredNot covered
Single Anastomosis Duodena-ileostomy with SleeveXX
NOTESNot coveredNot covered


Oscar Insurance provides both adult and adolescent weight loss surgery. Those seeking coverage must follow the following guidelines.

  1. Informed patient with an explanation of risks, benefits, and alternatives.
  2. An adult over 18 years old with documentation of:
    1. BMI equal to or greater than 40, or,
    1. BMI greater than or equal to 35 with one of the following:
      1. Medically proven cardiopulmonary disease
      1. Documented proof of coronary artery disease
      1. Documented proof of cardiomyopathy
      1. Medically refractory hypertension
      1. Type 2 diabetes
      1. Nonalcoholic fatty liver disease
      1. Osteoarthritis of the knee or hip
      1. Urinary stress incontinence

For adolescent patients 13-17 years old, a child’s stature must be within certain percentage parameters based on bone age or their BMI must be within a certain percentile for their age group to be considered. Also, like adults, unable to achieve weight loss goals with traditional non-surgical methods.

ProcedureCovered AdultCovered Adolescent
Roux-en-Y Gastric BypassXX
Gastric Banding (LAP-Band)XNot covered
Sleeve GastrectomyXX
Biliopancreatic Diversion with Duodenal Switch (without Switch)XNot covered
Vertical Band GastroplastyNot coveredNot covered
Mini-Gastric BypassNot coveredNot covered
NOTESNot coveredNot covered

Is weight loss surgery in Texas reversible?

With all insurance companies, in most cases, weight loss surgery is permanent.Revision of any bariatric procedure is considered experimental and not medically necessary unless the health of the patient is in jeopardy.


There is an answer to finding health insurance that covers weight loss in Texas. At CoverMile we do the hard work for you. We research the top companies and provide consumers like you with the information you seek to make an educated decision on the best weight loss surgery health insurance in Texas. Contact us today.

Frequently Asked Questions

  1. Does Texas health insurance cover weight loss surgery?

    Yes. While Texas is not one of the states where it is mandated, insurance companies will cover most types of weight loss surgery depending on the insurance provider and the type of surgery sought.

  2. Are there restrictions on who can have weight loss surgery in Texas?

    All insurance providers have requirements to have weight loss surgery done. Refer to each of these insurance providers’ guidelines. The most common among them is regarding one’s body mass index. The current 2024 level is greater or equal to a BMI of 40. Another is age. One must be an adult, over the age of 18, while there are procedures for those under 18 available with some insurance companies as with Cigna.

  3. Is weight loss surgery in Texas expensive?

    The cost would depend on the type of surgery you are having. Weight loss surgery can cost between $9000 and $25,000 or more, depending on the type of surgery and post-op treatment you have.

  4. What happens if my insurance company denies my weight loss surgery request?

    If your insurance company denies your request for weight loss surgery, you will either need to pay for the surgery out of pocket, or you can submit a letter of appeal. This letter will need to contain: an explanation of why you feel your surgery is warranted, a request for the insurance company to explain their reasoning behind their denial, a copy of your original denial, and a letter from your doctor’s preauthorization letter.

  5. Which insurance company has the best weight loss health insurance?

    Based on our review, in our opinion, Cigna would provide the greatest coverage for one seeking weight loss health insurance in Texas. They also provide coverage for those under 18.