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.

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.

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.

Procedure	Covered	Not Covered
Gastric Bypass	X
Gastric Banding	X
Sleeve Gastrectomy	X
Biliopancreatic Bypass	X
Vertical Banded Gastroplasty		X
Long Limb Gastric Bypass		X
Mini-Gastric Bypass		X
NOTES		X

Cigna

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:

ADULTS

For adults, the following must apply:

CHILDREN

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

Procedure	Covered Adult	Covered Adolescent
Roux-en-Y Gastric Bypass	X	X
Gastric Banding (LAP-Band)	X	Not covered
Sleeve Gastrectomy	X	X
Biliopancreatic Diversion with Duodenal Switch (without Switch)	X	Not covered
Vertical Band Gastroplasty	X	Not covered
Mini-Gastric Bypass	X	Not covered
NOTES	X	Not covered

UnitedHealthcare

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

And the individual must meet the following criteria.

OR

Procedure	Covered Adult	Covered Adolescent
Roux-en-Y Gastric Bypass	X	X
Gastric Banding (LAP-Band)	X	X
Sleeve Gastrectomy	X	X
Biliopancreatic Diversion with Duodenal Switch (without Switch)	X	X
Vertical Band Gastroplasty	X	X
Mini-Gastric Bypass	Not covered	Not covered
Single Anastomosis Duodena-ileostomy with Sleeve	X	X
NOTES	Not covered	Not covered

Oscar

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

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.

Procedure	Covered Adult	Covered Adolescent
Roux-en-Y Gastric Bypass	X	X
Gastric Banding (LAP-Band)	X	Not covered
Sleeve Gastrectomy	X	X
Biliopancreatic Diversion with Duodenal Switch (without Switch)	X	Not covered
Vertical Band Gastroplasty	Not covered	Not covered
Mini-Gastric Bypass	Not covered	Not covered
NOTES	Not covered	Not 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.

Summary

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.