Bariatric Surgery Cost in Washington

In Washington, whether bariatric surgeons include insurance coverage in their services can depend on several factors, including the specific insurance plan, the surgeon’s practice, and the type of bariatric procedure chosen. Insurance coverage for bariatric surgery can be complex and may vary from one provider to another.

In Washington, the coverage of bariatric surgery by insurance can vary depending on the specific insurance plan, the surgeon’s practice, and the type of bariatric procedure chosen. The Washington State Health Care Authority is currently reviewing its coverage policy for bariatric surgery, assessing the evidence on the clinical benefits and cost-effectiveness of including those defined by the level of obesity, age, and levels of comorbidity.

Additionally, the agency covers medically necessary bariatric surgery for eligible clients, and the coverage is evaluated based on the criteria of medical necessity, safety, effectiveness, and non-experimentality

●     Insurance coverage eligibility: Some insurance plans cover bariatric surgery, but eligibility criteria often include a minimum Body Mass Index (BMI) requirement and documentation of previous attempts at weight loss through diet and exercise.

●     In-network vs. out-of-network providers: The choice of a bariatric surgeon can impact insurance coverage. Many insurance plans have a network of preferred providers, and opting for an in-network surgeon may result in higher coverage. Out-of-network providers may be covered to a lesser extent, leading to increased out-of-pocket expenses for the patient.

●     Pre-authorization requirements: Insurance providers may require pre-authorization for bariatric surgery, involving a detailed review of the patient’s medical history, documentation of previous weight loss attempts, and other specific criteria.