{"id":2243,"date":"2022-10-03T10:00:20","date_gmt":"2022-10-03T04:30:20","guid":{"rendered":"https:\/\/www.insurancesamadhan.com\/blog\/?p=2243"},"modified":"2022-11-17T09:46:28","modified_gmt":"2022-11-17T04:16:28","slug":"do-health-insurance-cover-weight-loss-or-bariatric-surgery","status":"publish","type":"post","link":"http:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/","title":{"rendered":"Do Health Insurance Cover Weight Loss or Bariatric Surgery?"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_76 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/#Does_Health_Insurance_Cover_Bariatric_Surgery\" >Does Health Insurance Cover Bariatric Surgery?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/#Point_to_be_Noted\" >Point to be Noted:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/#Read_How_Insurance_Samadhan_Resolved_an_Insurance_Claim_Rejection_Case_Related_to_Bariatric_Surgery\" >Read How Insurance Samadhan Resolved an Insurance Claim Rejection Case Related to Bariatric Surgery<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/#Click_on_the_below_links_to_read_some_cases_resolved_by_Insurance_Samadhan\" >Click on the below links to read some cases resolved by Insurance Samadhan:<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<p>Dieting and exercise can be challenging for people who are overweight and have a higher BMI. There are cases of obesity where doctors recommend bariatric surgery to avoid any health issues in the future.<\/p>\n<p>Bariatric surgery is a surgical procedure that helps lose weight by making changes to the digestive system. It is a good option for those patients who meet the medical criteria and for whom, diet and workout are not effective.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-2251\" src=\"https:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery.jpg\" alt=\"Do Health Insurance Cover Weight Loss or Bariatric Surgery?\" width=\"1920\" height=\"1080\" srcset=\"http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery.jpg 1920w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery-300x169.jpg 300w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery-1024x576.jpg 1024w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery-150x84.jpg 150w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery-768x432.jpg 768w, http:\/\/www.insurancesamadhan.com\/blog\/wp-content\/uploads\/2022\/10\/Do-Health-Insurance-Cover-Weight-Loss-or-Bariatric-Surgery-1536x864.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Does_Health_Insurance_Cover_Bariatric_Surgery\"><\/span>Does Health Insurance Cover Bariatric Surgery?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In health insurance policies bariatric surgery was a standard exclusion. However, after the 2019 Guidelines of the Insurance Regulatory and Development Authority of India (IRDAI), bariatric or weight loss surgery is included in Health Insurance policies.<\/p>\n<p>However, expenses related to bariatric surgery for obesity will be included when the following conditions are fulfilled:<\/p>\n<ol>\n<li>The doctor advises the surgery<\/li>\n<li>The insured patient must be at least 18 years old<\/li>\n<li>Body Mass Index (BMI) must be:<\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Greater than or equal to 40 or<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Greater than or equal to 35 with any of the following co-morbidities:<\/span><\/li>\n<\/ul>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Sleep Apnea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Type 2 Diabetes (uncontrolled)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Coronary heart disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Obesity-related cardiomyopathy<\/span><\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/stage.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Insurance Samadhan\" width=\"500\" height=\"70\" border=\"0\" \/><\/a><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Point_to_be_Noted\"><\/span>Point to be Noted:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A <a href=\"https:\/\/www.insurancesamadhan.com\/blog\/8-reasons-why-you-must-have-health-insurance\/\">health insurance<\/a> company will not cover bariatric surgical procedures in the following cases:<\/p>\n<ol>\n<li>Surgery is done due to cosmetic\/aesthetic reasons<\/li>\n<li><a href=\"https:\/\/www.insurancesamadhan.com\/blog\/non-disclosure-of-pre-existing-diseases-can-lead-to-trouble\/\">Pre-existing conditions<\/a> related to claims<\/li>\n<li>Claim during the initial waiting period of 30 days for the health insurance policy will be rejected.<\/li>\n<li>Obesity due to<\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drugs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Psychiatric and eating disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Untreated hormonal imbalance<\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Read_How_Insurance_Samadhan_Resolved_an_Insurance_Claim_Rejection_Case_Related_to_Bariatric_Surgery\"><\/span>Read How Insurance Samadhan Resolved an Insurance Claim Rejection Case Related to Bariatric Surgery<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Manoj\u2019s wife was suffering from Morbid Obesity with Obstructive Sleep Apnoea and bilateral knee pain for a long time. Her treating doctor advised her to lose weight. She tried a lot and reduced some weight. However, she gained it again. Her BMI came out to be more than 40. Her doctor recommended bariatric surgery that would help her lose weight. She was admitted to the hospital and had her surgery.<\/p>\n<p>Manoj informed about the surgery to TPA. He submitted the claim form along with the necessary documents for <a href=\"https:\/\/www.insurancesamadhan.com\/blog\/a-guide-to-health-insurance-reimbursement\/\">reimbursement<\/a>. However, her claim was rejected by TPA stating that the surgery is not covered under the terms and conditions of the policy.<\/p>\n<p>The couple became worried as the expenses were quite high. Manoj tried multiple times to explain his case to the TPA but failed to get reimbursed. Then he approached Insurance Samadhan. We investigated the case and found it to be genuine. We guided him and helped him get his reimbursement.<\/p>\n<p>If you have any problem related to your insurance, you can approach Insurance Samadhan. We have resolved 14,500+ insurance-related complaints. Contact us to get samadhan for your insurance-related issues, we\u2019ll be happy to help you.<\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"Click_on_the_below_links_to_read_some_cases_resolved_by_Insurance_Samadhan\"><\/span>Click on the below links to read some cases resolved by Insurance Samadhan:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/blog\/dengue-insurance-coverages-and-exclusions\/\">Dengue Claim Rejection<\/a><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/blog\/top-5-reasons-for-death-claim-rejection\/\">Death Claim Rejection<\/a><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/blog\/cashless-claims-in-health-insurance\/\">Cashless claim rejection<\/a><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><strong>Click here<\/strong><\/a>\u00a0to register your complaint with Insurance Samadhan<\/p>\n<p>You can also<\/p>\n<p>Visit our website:\u00a0<a href=\"https:\/\/www.insurancesamadhan.com\/\">insurancesamadhan.com<\/a><\/p>\n<p>Call us on +91 9513631312<\/p>\n<p>WhatsApp:\u00a0<a href=\"https:\/\/api.whatsapp.com\/send?phone=+919910998252&amp;text=Hi\">9910998252<\/a><\/p>\n<p>Mail us at\u00a0<a href=\"mailto:corporate@insurancesamadhan.com\">corporate@insurancesamadhan.com<\/a><\/p>\n<p><a href=\"https:\/\/www.insurancesamadhan.com\/register?utm_source=organic&amp;utm_medium=blog&amp;utm_campaign=blog_post&amp;utm_term=blog_term\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/stage.insurancesamadhan.com\/assets\/img\/contact.png\" alt=\"Insurance Samadhan\" width=\"500\" height=\"70\" border=\"0\" \/><\/a><\/p>\n<p><script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\/\",\n  \"@type\": \"Article\",\n  \"mainEntityOfPage\": {\n    \"@type\": \"WebPage\",\n    \"@id\": \"https:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/\"\n  },\n  \"headline\": \"Do Health Insurance Cover Weight Loss or Bariatric Surgery?\",\n  \"description\": \"Bariatric surgery is a surgical procedure that helps lose weight by making changes to the digestive system. 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There are cases of obesity where doctors recommend bariatric surgery to avoid any health issues in the future. Bariatric surgery is a surgical procedure&hellip; <a href=\"http:\/\/www.insurancesamadhan.com\/blog\/do-health-insurance-cover-weight-loss-or-bariatric-surgery\/\" class=\"more-link\">Continue Reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":2252,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[3,20],"tags":[220,218,219,222,221],"class_list":["post-2243","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-insurance","category-insurance-claim","tag-health-insurance-for-bariatric-surgery","tag-morbid-obesity","tag-obesity","tag-obstructive-sleep-apnoea","tag-sleep-apnea"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Do Health Insurance Cover Weight Loss or Bariatric Surgery?<\/title>\n<meta name=\"description\" content=\"Bariatric surgery is a surgical procedure that helps lose weight by making changes to the digestive system. 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